r 


LIBRARY 

UNIVERSITY  OF 
CALIFORNIA 
SAN  DIEGO 


^^BMJ  BIOMEDICAL  LIBRARY 

UNIVERSITY  OF  CALIFORNIA,  SAN  DIEGO 
LA  JOLLA,  CALIFORNIA 


J 


DATE  DUE 

Mm. 

9m'c 

I  8  REC'C 

" ' 1 

CAVLORO 

PRINTED  INU.S    A. 

5^7c  - 


Digitized  by  the  Internet  Archive 

in  2008  with  funding  from 

IVIicrosoft  Corporation 


http://www.archive.org/details/aroundworldviainOOsenn 


AROUND  the  WORLD 
via   INDIA  =^= 

A  MEDICAL  TOUR 

BY 

Ntd)iilafi  ^mi.  H.i.,  it|.i-,  CIC.i.,  ^M. 

Professor  of  Surgery    Uni'versity  of  Chicago — Professor  and  Head  of  the 

Surgical  Department  Rush   Medical   College — Surgeon-in- Chief  St. 

yoseph^s  Hospital — Attending  Surgeon  Presbyteriati   Hospital 

— Surgeon  General  of  Illinois- — Lieutenant   Colonel  and 

Chief  of  the  Operating  Staff  with  the  Armf  in  the 

Field  During  the  Spanish-American  JVar^  etc. 


CHICAGO: 

AMERICAN    MEDICAL  ASSOCIATION    PRESS 

1905 


PREFACE 

ZhiQ  booh  is  more  especially 
inten&eCt  for  m^  proteselonal 
frlen&s  wbom  II  bave  met 
J)urfnfl  m^  travels  in  Differ* 
ent  parts  of  tbe  worlD,  anD 
to  wbom  If  am  cbiefl\)  ln= 
Debtee  for  manv  courtesies 
an&  mucb  information.  (Tbe 
text  consists  of  a  series  of 
articles  publisbeD  in  (Tbe 
Journal  of  tbe  Bmerican 
/DbeDical  association  During 
tbe  last  sir  montbs  of  tbe 
^ear  past.  /IBan^  new  illus= 
trations  bave  been  aDDcD 
wbicb  tbe  autbor  bopes  will 
enbancetbe  value  of  tbe  booft 

N.  SENN 
Chicago,  [une  15,   1905 


CONTENTS 


Page. 

Travel  as  a  Means  of  Post-Graduate  Medical  Educa- 
tion           9 

Leprosy  in  the  Hawaiian  Islands:  The  Proposed  Es- 
tablishment of  a  Government  Bacteriologic  Institute — 
Segregation — A  Fighting  Leper — The  Leper  Settlement 
on  the  Island  of  Molokai— A  Government  Bacteriologic 
Laboratory  and  Station  for  the  Scientific  Study  of  Lep- 
rosy— The  Island  of  Molokai  as  a  Home  for  Lepers.  ...     21 

Father  Damien,  the  Leper  Hero:  A  Heroic  Brother — The 
Leper  Priest  Dies  of  Leprosy 29 

Medical  Affairs  in  the  Hawaiian  Islands:  Historical 
Sketch  of  the  Islands — Climate — Native  Population — 
Prevailing  Diseases — The  Medical  Profession — Queen's 
Hospital — Medical    Society   of  the   Hawaiian   Territory.      45 

Our  PoSvSession  in  Samoa  from  a  Medical  Standpoint: 
Sketch  of  the  History  of  the  Islands  of  Samoa — Our 
Samoan  Island — Climate — The  People — Present  Form  of 
Government — Kava  Drinking — Native  Houses — Diseases 
— Hospitals 61 

New  Zealand:  The  Ocean  Voyage — Climate — (Natives — 
Auckland — Auckland    Hospital — Medical    Pi-ofession  ....      85 

Australi.\:  The  Kangaroo — Climate — Prevailing  Diseases 
— People — Natives — The  Mika  or  Kulpi  Operation — 
Surviving  Aborigines — Sydney — .Hospitals — Sydney  Hos- 
pital— Royal  Prince  Alfred  Hospital — Medical  Profes- 
sion          99 

The  Melbourne  Hospitals:   The  Melbourne  Hospital — 
•  Radical   Cure  for  Inguinal  Hernia — Prostatectomy — Al- 
fred Hospital — Melbourne  Hospital  for  Sick  Children — 
St.  Vincent's  Hospital — A  Trip  to  the  Giant  Eucalyptus 
Trees    125 

The  Adelaide  Hospitals:  The  Adelaide  Hospital — 
Adelaide  Children's  Hospital — Gallstone  in  Elephants — 
Postmortem  on  a  Zebra — Private  Hosi)itals  in  Australia 
— Terrace   Hospital — Clareton   Hospital    139 


VI  COXTKNTS. 

Page. 
.Mtnlioal    Kducation    in    Australia:    Sydney    University 
and  ^Medical  School — ^lelbourne  University  and  Medical 
School — Adelaide   University  and  Medical   School 155 

Ceylon :  From  Australia  to  Ceylon — Island  of  Ceylon;  Its 
Climate,  People;  Prevailing  Diseases — Soysa  Bacterio- 
logic  Institute,  Colombo — Tlie  General  Civic  Hospital — 
Ceylon  Medical  College — Leper  Asylum  at  Hendala — 
Leper  Buddhist  Celebration — City  of  Kandy — The  An- 
nual Buddha  Celebration — Botanical  Garden — Kandy 
■  General    Civic   Hospital    167 

India  :  ^ladras  Medical  College — Dress,  for  Natives  Only 
— Madras  Government  General  Hospital — Carcinoma  in 
India — Abscess  of  the  Liver — Aneurism  of  Common  and 
External  Carotid  Arteries — Hydatid  Cyst  of  Tibia — Rhi- 
noscleronia    197 

Bengal  Medical  College:  Female  Certificate  Class — 
The  Surnomoye  Hostel — JVlilitary  Pupil  Class — Mid- 
wives    and    Dias     213 

Calcutta  Govermuent  Cciieial  Hospital:  The  City  of 
Jaipur  and  ^layo  Ilosintal;  Splenic  Anemia — Piroi^lasma 
Donovani    229 

Grant  Alcdical  College  and  the  Hospitals  of  Bombay: 
Pathologic  Museums — Pneumonic  Plague — Syphilitic 
Fibrosis  of  the  Lung — Aneurism  of  the  Heart — Hepatic 
Abscess — Enormous  Calculus  of  the  Bladder — Ainhum  of 
the  Small  Toe — Mycetoma  or  Madura  Foot — Anesthetic 
Leprosy — Guinea  Worm — Jamsetjee  Jeejeebhoy  Hospital 
— Prevalent  Diseases — Homeless  Leper  Asylum,  Batunga 
— Tlie  Plague  Research  Laboratory  of  the  Government  of 
India,  Pare! — ^Bombay  Bubonic  Plague  Hospital — A 
Cobra   Den — Calmette's   Antivenene    247 

Four  Thousand  Miles  Througli  India  by  Rail  in  ^lid- 
sinnmer:  Attractions  of  India — Master  and  Servant — 
Indian  Summer  Climate — The  People — Indian  Art — No- 
table Medicinal  Trees  of  India — Benares  Monkey  Tem- 
ple— A  Benares  Saint — Hindu  Cremation — Taj  ^Nlahal — 
Delhi — A  Parsee  Woman  Doctor — A  Sick  Elephant — A 
Crocodile  Tank — A  Belated  Bridal  Ceremony — Feast  of 
the  New  Moon — A  Faithful  Roman  Catholic  Priest — 
Elejihanta  Caves — A  Grewsome  Charnel  House 277 


ILLUSTRATIONS 


Figure.  Page. 

1.  Tubercular    L('i)rosy   in   a   Youii"-   Native   (Jiil 23 

2.  Tubi'ifular    Leprosy  in  a   Hawaiian    24 

3.  Island    of    Molokai     25 

4.  Anesthetic   Leprosy    in    a    Native    Woman 27 

5.  Baldwin  Home  for    Leper   Boys,   Kalawao,  Molokai...      28 

6.  Father    Damien    31 

7.  Kalawao    Leper    Settlement.    Molokai.    Established   by 

the    Hawaiian    Government    in    ISOo,    Showing    Also 
Father  Damien's   Churcli    35 

8.  Father    Damien"s    Grave     41 

9.  Natives    and    Native    House 47 

10.  Liiau,  National  Hawaiian  Feast    49 

11.  The  Government  House,  Honolulu    51 

12.  Queen  Emma,  Consort  of  King  Kamehameha  III....     53 

13.  Queen's     Hospital,     Honolulu,     Established     by     King 

Kamehameha  III  and  Queen  Emma  in  1860 55 

14.  Tutuila.    Samoa,   U.    S.    Naval    Station 63 

15.  Flag-raising   Ceremonies    65 

16.  Samoan   Women   and    Child    67 

17.  Tamasese,  Fine  Specimen  of  Samoan 71 

18.  A  Native  of  Tutuila  Affected  with  Elephantiasis  Af- 

fecting   All    Extremities    75 

19.  Native  Hospital  in  Pago  Pago,  Tutuila    79 

20.  Swa  Dance  in  Tutuila,  July  4,  1904,  in  Front  of  Naval 

Hospital 83 

21.  INIaori    Women     89 

22.  Auckland   Hospital    95 

23.  Australian   Aborigines    110 

24.  Aborigines  of  Central  Australia  in  War  Dress Ill 

25.  Young  Native  Mother  and  Infant 115 

26.  The  University  of  Sydney,  Overlooking  Victoria  Park.    119 

27.  The  Original  Medical  School,  University  of  Sydney.  .  .    120 

28.  View  of  Sydney  Hospital  from  the  Northwest 121 

29.  The  Operating  Theater.   Sydney  Hospital 122 

30.  Adelaide    Hospital     141 

31.  View  on  the  Grounds;   Adelaide  Childrens'  Hospital..    149 

32.  Medical  School  LTniversity  of  Sydney 161 


VIII  ILLUSTKATIOXS. 

liGURE.  Page. 

33.  A   Singhalese    175 

24.  Singhalese  Woman    179 

35.  Leper  Asylum  at  Hendala   189 

36.  Tooth  of  Buddah   191 

37.  Madras  Medical  College  and  Government  General  Hos- 

pital       198 

38.  Another  View  of  Madras  Medical  College  and  Govern- 

ment General  Hospital 199 

39.  Chondrosarcoma  of  Humerus  and  Scapula 203 

40.  Bengal  Medical  College,  Calcutta 213 

41.  Quarters  for  Military  Pupils    215 

42.  Eden    Hospital,    Calcutta    221 

43.  Elephantiasis    of    Legs     223 

44.  An   Undiagnosed   Case    225 

45.  Native    of   Jaipur    230 

46.  Hindu   Dancing   Girl    231 

47.  Piroplasma    Donovani     243 

48.  A  Parsee    249 

49.  Anatomy  Building,  Grant  Medical  College  251 

50.  Madura   Foot    257 

51.  Keloid  of  Punctured  Lobe  of  Ear    259 

52.  Operating  Room,  Jamsetjee  Jeejeebhoy  Hospital 261 

53.  Hindu    Snake    Charmer     273 

54.  Master    and    Servant    285 

55.  Hindu    Butler     287 

56.  An   Indian   Faquir    295 

57.  An  Arab  Jew  in  India    297 

58.  Hindu   Women    301 

59.  A    Sikh    Priest     305 

60.  Low    Caste   Hindu   Girls 307 

61.  An  Illustration  of  Hindu  Architecture 311 

62.  The  Colonnade  in  the  Hindu  Temple  at  Rameshwaram.  313 

63.  Open    Air    Cremation 317 

64.  Swanii  Bhaskara  Nand  Saraswati,  the  Famous  Ascetic 

of    Benares    320 

65.  Taj    Mahal    321 

66.  Tower   Near    Delhi    325 

67.  City    of    Delhi    327 

68.  Native    Policemen     331 

69.  Botanical    Garden,    Calcutta 337 

70.  Towers  of  Silence    343 


TRAVEL    AS    A    MEANS    OF    POST-GKADTTATE 
.MEDICAL    Li)r(AT10X. 


For  tlie  second  time  I  am  on  a  tour  aronnd  the  world 
— this  time  in  an  ojaposite  direction,  from  East  to  AVcst, 
via  Jndia.  I  leave  San  Francisco  on  the  steamer  Sierra, 
Jul}'  7,  and  if  I  am  spared  the  disease-producing  effects 
of  the  tropical  climate  and  not  delayed  by  failing  to 
make  timely  connections^  I  expect  to  reach  New  York 
on  the  Kronprinz  Wilhelm,  October  11.  Three  years 
ago  I  girdled  the  globe  via  Siberia  in  three  months 
and  twenty  days.  That  trip  was  replete  with  informa- 
tion of  all  sorts,  general  and  professional,  and  the 
pleasure  of  it  was  enhanced  by  the  companionshii)  of 
my  friends.  Prof.  D.  E.  Browor  and  Drs.  Mastin  and 
Frank. 

I  am  very  well  aware  of  the  fact  that  midsummer 
is  the  wrong  time  to  undertake  a  journey  through  India, 
owing  to  the  intensity  of  the  heat,  but  I  expect  to  re- 
ceive at  least  a  partial  recompense  for  the  expected 
sufferings  incident  to  unfavorable  climatic  conditions 
by  avoiding  crowded  hotels,  cars  and  steamers,  which 
so  often  detract  from  the  pleasures  and  benefits  of  travel 
during  the  winter  season,  when  the  tourists  elbow  their 
way  over  this  popular  pathway  around  the  world.  This, 
at  least,  was  my  experience  in  visiting  the  Holy  Land 
and  Egypt  during  the  summer  months  on  a  former  oc- 
casion. 

Beside,  the  duties  of  my  college  work  are  such  as  to 
preclude  all  possibility  of  seeing  India  at  the  most  de- 
sirable time.     My  friends  who  had  comtemplated  mak- 


10  AROUND    THE    WORLD    VIA    INDIA. 

iny  til  is  long  joiirue}'  with  nie  have  all,  oue  after  the 
other,  decided  otherwise,  so  I  shall  find  myself  alone 
for  once  from  one  end  of  the  world  to  the  other.  This 
isolation  also  has  its  advantages  and  charms.  The  time 
will  he  long  to  me  exclusively  and  I  shall  dispose  of  it 
in  the  most  profitable  manner  in  studying  the  different 
places  of  greatest  interest,  the  people,  their  customs 
and  habits.  1  shall  also  devote  special  attention  to 
matters  pertaining  to  our  profession  and  report  from 
time  to  time  to  the  readers  of  The  Journal  the  results 
of  my  observations.  Experience  has  taught  me  that  in 
traveling  in  tropical  countries  the  best  means  to  counter- 
act the  baneful  effects  of  heat  is  work,  mental  and  physi- 
cal. It  is  under  the  influence  of  prolonged  heat  that 
inactivity  begets  mental  and  physical  languor,  while 
exercise  of  body  and  mind  increases  the  force  of  the 
enfeebled  circulation  and  stimulates  the  organs  of  secre- 
tion and  excretion  to  greater  activity.  Before  leaving 
.the  Pacific  Coast  I  desire  to  discuss  very  briefly  the 
subject  indicated  by  the  title  of  this,  my  first  communi- 
cation, and  in  doing  so  I  fully  realize  what  Cicero  said 
of  letter-writing : 

"We  write  dirteieiitly  wlieii  we  think  tluit  those 
only  to  whom  we  write  will  read  our  letters,  and  in 
a  different  style  when  our  letters  will  be  seen  by 
many." 

My  prospective  letters  mean  letters  to  the  over  31,000 
subscribers  of  the  official  organ  of  the  American  Medi- 
cal Association,  many  of  whom  I  count  among  my  most 
esteemed  and  intimate  friends,  hence  my  diffidence  and 
uneasiness  in  beginning. 

From  time  immemorial  travel  has  been  recognized  as 
an  important  element  in  acquiring  a  general  education 
and  in  obtaining  proficiency  in  the  professions,  arts, 
sciences  and  trades. 

It  is  the  study  of  men  and  manners  in  different 
climes  and  varying  social  and  political  conditions  that 
proves   so    iisi'fu!    in    enlarging   the   vi(>ws   of   life   and 


■|'i;.\\i;l  as  a   .mkdicai.  I'DIcaiion.  11 

\V('i,uliin^'  its  possiMlii  its.      llorjiiiiis  was   Fully  awari'  of 
this  wlii'ii   lie  wrote: 

"Tho  kiiowlodjie  of  uieii  and  niainicrs  is  the  lirst 
principle  and  fountain  head  of  good  writing." 

Before  machinery  nsurperl  tlic  jjlace  of  hand  labor 
mechanics  and  tradesmen  acquired  their  technical 
knowk>dge  by  serving  as  apprentices  for  a  number  of 
years  under  the  supervision  of  an  acknowledged  master, 
and  after  having  obtained  the  required  proficiency  they 
spent  another  year  or  two,  their  Wander jahre,  in  travel- 
ing from  ])lace  to  place  in  perfecting  themselves  in  their 
vocation  by  familiarizing  themselves  with  the  practical 
work  of  different  masters,  before  they  considered  them- 
selves fully  qualified  to  take  their  independent  stations 
in  life.  In  this  manner  they  acquired  a  reliable  knowl- 
edge of  the  details  of  their  work,  which  no  one  master 
could  impart.  If  travel  and  observation  and  practice 
under  different  masttu's  in  the  acquirement  of  a  thor- 
ough knowledge  of  the  different  trades  are  such  im- 
portant factors  of  success  in  the  world  of  business,  it 
must  appear  very  evident  that  the  same  means  are  even 
more  desirable  and  efficient  in  the  study  of  medicine 
and  in  keeping  pace  with  the  wonderful  advancements 
and  improvements  of  the  most  progressive  of  all  profes- 
sions. In  this  age  of  research  and  discoveries,  the 
science  and  the  practice  of  medicine  and  surgery  are 
undergoing  revolutionary  changes  from  day  to  day, 
and  the  ceaseless  search  for  truth  and  facts  makes  it 
necessary  for  the  modern  practitioner  to  keep  abreast 
with  the  latest  and  best  pertaining  to  his  calling. 

In  our  day  this  means  much.  It  was  not  so  in  the 
remote  past,  when  the  authority  of  writers  of  popular 
text-books  remained  unchallenged  for  centuries.  We 
live  in  an  age  characterized  by  progressiveness.  deep 
scientific  investigation,  free  and  sharp  criticism.  Theo- 
ries advanced  by  one  are  overthrown  by  another  unless 
they  stand   the  crucial  test  of  successful   repetition  by 


12  AKOUND    THE    WOKLD    VIA    INDIA. 

acknowledged  leaders  in  the  profession.  \Yhat  was  new 
yesterday  may  become  old  and  obsolete  to-morrow.  Sci- 
entific work  is  no  longer  confined  to  a  few  favored 
institutions;  it  may  be  seen  in  all  parts  of  the  civil- 
ized globe.  Nations  and  institutions  are  now  engaged 
in  a  laudable  competition  to  excel  in  blazing  new  path- 
ways through  the  still  unexplored  territories  of  scientific 
medicine.  It  is  by  the  concerted,  systematic,  scientific 
investigation  of  disease  in  all  climes  and  under  varying 
conditions  that  we  must  look  for  more  radical  measures 
in  the  prevention  and  more  successful  treatment  of 
disease.  There  is  no  time  in  the  life  of  a  medical  man 
when  he  feels  more  confident  and  competent  to  battle 
successfully  with  disease  and  perform  the  most  diffi- 
cult operations  than  on  the  day  he  leaves  his  alma  ma- 
ter, diploma  in  hand,  ready  to  seek  his  place  in  the 
crowded  ranks  of  his  future  profession.  If  the  new  as- 
pirant for  a  liberal  patronage  is  honest,  it  will  not  take 
him  long  to  discover  his  shortcomings  and  crave  for 
more  knowledge.  He  will  be  made  painfully  aware  of 
the  fact  that 

"Because  all  the  sick  do  not  recover,  therefore 
medicine  is  no  art." — Cicero. 

The  completion  of  the  study  of  medicine,  even  in 
the  best  equipped  medical  colleges  and  universities,  fur- 
nishes at  best  but  the  foundation  for  the  subsequent 
post-graduate  education.  If  the  foundation  is  firm  and 
the  building  material  contributed  later  substantial  and 
in  sufficient  abundance,  the  resulting  structure  will  re- 
sist fire,  wind  and  storm,  a  lasting  monument  to  the 
builder.  If  the  foundation  is  defective  and  the  build- 
ing material  not  of  the  right  sort,  failure  and  disap- 
pointment will  surely  follow  misdirected  efforts,  no 
matter  how  earnest  and  persistent  they  have  been. 
The  successful  physician  and  surgeon  will  be  the  one 
who,  with  the  day  of  his  graduation,  enters  on  a  ra- 
tional,  woU-plannofl.  systematic  post-graduate  course  of 


THAVEL   AS   A    MEDICAL    EUUCATIOX.  13 

the  study  of  medicine  and  its  allied  sciences.  This 
constitutes  a  life  study.  Without  it  the  practice  of 
medicine  inevitably  soon  degenerates  into  a  miserable 
trade.  The  reading  of  new  text-books  and  the  best 
current  medical  literature,  passive  and  active  work  in 
medical  societies,  local,  national  and  international,  lab- 
oratory work  in  the  office  and  local  hospitals,  are  well 
calculated  to  meet  the  needs  of  the  ambitious,  conscien- 
tious practitioner,  but  they  will  not  suffice  in  giving 
him  the  best  possible  opportunities  to  keep  in  touch 
with  the  spirit  and  practice  of  the  extraordinary  age 
in  which  we  live.  Beading  and  seeing  are  two  entirely 
different  things.  The  eye  is  the  great  educator  in  tech- 
nics of  all  kinds.  It  is  one  thing  to  read  the  descrip- 
tion of  a  complicated  operation;  it  is  another  thing  to 
see  it  performed  by  the  hands  of  a  master.  Text- 
books, valuable  as  they  are,  are  but  poor  substitutes 
for  actual  instruction  and  demonstrations  in  clinical 
and  laboratory  methods.  Personal  intercourse  with 
prominent  men  in  the  profession  imparts  a  stimulation 
for  more  earnest  and  more  effective  efforts  not  obtain- 
able to  the  same  extent  in  any  other  way. 

A  personal  acquaintance  with  men  who  have  earned 
a  well-merited  reputation  in  the  advancement  of  our 
profession  is  a  source  of  great  gratification  and  excites 
a  new  interest  in  the  work  he  has  accomplished.  The 
study  of  strange  diseases  in  distant  countries  fills  a  gap 
which  a  college  education  and  subsequent  reading  can 
not  fill.  An  accurate  knowledge  of  climatic  conditions 
and  their  effects  on  health  and  disease  can  only  be  ac- 
quired by  travel. 

For  the  professional  man,  and  especially  for  the  phy- 
sician, travel  opens  a  field  of  learning  and  affords  op- 
portunities the  importance  of  which  can  not  be  over- 
estimated. In  order  that  travel  may  yield  the  desired 
results,  both  physically  and  mentally,  it  must  be  care- 
fully planned  and  properly  conducted.     The   demands 


14  AROUND    THE   WORLD    VIA    INDIA. 

on  the  time  and  energies  of  an  exacting,  laborious 
practice  are  such  that  fatigue,  bodily  and  mental,  must 
follow  sooner  or  later.  Of  all  learned  professions  the 
medical  is  the  one  in  greatest  need  and  most  deserving 
of  a  long,  free-of-care  annual  vacation.  It  is  hard  to 
make  the  public  believe  this,  but  it  is  nevertheless  true. 
During  the  summer  months  the  complicated  mechanism 
of  the  law  comes  to  a  standstill  and  the  lawyers  take 
their  vacation  without  crippling  their  bank  account  to 
any  considerable  extent.  The  fashionable  cburche> 
close  their  doors  when  the  members  of  the  congrega^ 
tions  leave  for  their  luxurious  summer  homes,  and  the 
rectors  and  preachers,  with  purses  well  filled  with  gold 
by  their  appreciative  parishioners  for  their  vacation 
expenses,  leave  the  great  cities  and  spend  their  allotted 
leisure  weeks  and  months  where  they  are  sure  to  find 
rest,  comfort  and  recreation.  It  is  the  physician  who 
is  expected  to  work  from  one  end  of  the  year  to  the 
other,  ready  for  call  by  day  and  night,  in  sunshine 
and  storm.  It  is  the  physician  whose  annual  income 
suffers  when  he  leaves  his  practice  for  a  much-needed 
outing.  It  is  the  physician  who  carries  away  with  him 
the  weight  of  .his  responsibilities  to  a  greater  extent 
than  the  members  of  any  other  profession  when  away 
from  daily  routine  work.  The  public  must  be  made  to 
understand  that  medical  men  are  entitled,  above  any 
other  profession  or  class  of  men,  to  an  annual  vacation, 
and  that  such  vacation,  properly  spent,  will  bring  to 
their  patients  better  service,  and  will  be  one  of  the  most 
important  factors  in  promoting  the  science  of  modi- 
cine,  public  hygiene  and  sanitation. 

Where  and  how  shall  the  physician  spend  his  vaca- 
tion? 

•'Travel,  in  the  younger  sort,  is  a  part  of  educa- 
tion; in  the  elder,  a  part  of  experience." — Bacon. 

The  physician  who  has  the  interests  of  his  patients 
and  profession  at  heart  will  not  be  content,  like  most 


TKAVJ'L   AS   A   MEDICAL   EDUCA'J'IUN.  15 

professional  and  business  men,  to  spend  liis  precious 
vacation  time  in  idleness  at  some  fashionable  seashore 
or  mountain  resort  or  to  imbibe  the  questionable  p'eas- 
ures  of  city  life.  The  working  time  of  a  professional 
career  is  too  short  to  waste  time  by  idleness  or  dissi- 
pation. Eest  to  him  means  work  of  the  right  kind. 
What  wears  a  busy  doctor  out  is  not  the  physical  work 
he  does,  but  the  care  and  sense  of  responsibility  it  car- 
ries with  it.  The  greatest  pleasure  to  him  is  to  see 
others  work,  and  the  sweetest  rest  a  freedom  from  care. 
Brain  fatigue  is  more  frequently  caused  by  care,  real  or 
imaginary,  than  overwork.  A  man  in  average  health 
can  do  an  incredible  amount  of  congenial  work,  but 
it  is  care  that  furrows  the  face  and  blanches  the  hair 
prematurely. 

Relieved  of  care  the  physician  on  his  vacation  is  in 
the  best  possible  mood  to  reap  the  benefits  of  the  work 
of  others  near  and  far.  The  visits  to  laboratories,  hos- 
pitals and  museums,  the  personal  contact  with  col- 
leagues in  different  countries,  the  inspection  of  new  in- 
struments, the  practical  work  in  the  operating  room  and 
laboratory  will  become  to  liim  fascinating  and  instruc- 
tive object  lessons.  The  genuine  feeling  of  fraternity 
among  medical  men  throughout  the  entire  world  will 
insure  to  the  earnest  and  honest  seeker  of  knowledge 
a  most  friendly  reception,  provided  the  visitor  conducts 
himself  properly.  The  American,  born  in  a  land  where 
the  idea  of  equality  among  men  is  pre-eminent,  in  order 
not  to  give  unintentional  offense,  must  adapt  himself 
to  the  customs  of  the  countries  he  visits,  and  thereby 
secure  the  good  will  and  friendship  of  those  whose  work 
he  is  privileged  to  see. 

In  Europe  the  matter  of  titles  conferred  by  the  gov- 
ernments on  medical  men  is  confusing  to  the  American 
visitor.  Fortunately  our  forefathers  guarded  against 
anything  reminding  one  of  royalty  to  take  foothold  on 
our  soil.  In  Europe  and  any  of  the  European  posses- 
sions and  Japan  a  titled  person  must  be  recognized  and 


16  AROUND    THE   AVOELD    VIA    INDIA. 

treated  as  sucli.  The  title  of  professor  there  means 
much  more  thau  with  us,  for  tlie  reason  tliat  it  can  not 
be  made  use  of  without,  being  granted  by  the  govern- 
ment. A  professor  must,  therefore,  not  be  addressed 
as  doctor,  as  is  customary  in  our  country,  where  the 
freshman  medical  student  does  not  hesitate  to  make 
use -of  this  common  and  familiar  term  in  addressing  his 
teachers,  and  if  he  comes  from  some  rural  district, 
where  physicians  are  too  familiar  with  their  clients  and 
neighbors,  he  may  be  bold  enough  to  shorten  the  word 
to  "doc." 

As  soon  as  a  European  professor  is  honored  by  a 
government  title  he  has  a  decided  preference  for  the 
latter,  hence,  if  he  is  a  Lord,  Sir,  Excellency,  Geheim- 
rath,  Baron,  Pasha,  Bey,  etc.,  he  expects  to  be  addressed 
by  the  titles  with  which  he  has  been  honored. 

Another  thing  the  traveling  physician  should  always 
be  mindful  of,  and  that  is  not  to  pester  the  teacher  or 
operator  with  unnecessary  questions.  Many  of  these 
men  we  meet  arc  very  busy,  and  their  temper  is  some- 
times ruffled  by  overwork.  The  assistants,  less  burdened 
with  responsibilities,  are  alwa^^s  glad  to  give  the  re- 
quired information  if  approached  properly  and  at  an 
opportune  time.  The  firing  of  questions,  often  of  an 
irrelevant  nature,  at  a  busy,  overburdened  professional 
man,  is  in  exceedingly  bad  taste,  and  can  hardly  fail 
to  excite  his  displeasure.  The  physician  away  from 
his  cares  and  strenuous  duties  should  not  undertake  to 
teach  or  to  instruct,  but  should  devote  all  available  time 
to  add  to  his  knowledge  by  seeing,  hearing  and  reading. 
The  visiting  phj^sician  must  become  a  well-squeezed 
sponge,  ready  and  eager  to  absorb,  slow  in  offering  .ad- 
vice and  in  exhibiting  his  operative  skill.  The  display 
of  technical  skill  in  strange  hospitals  and  clinics  should 
be  discouraged,  as  the  operator  labors  under  the  great 
disadvantage?  of  doing  his  work  with  unfamiliar  instru- 
ments and  strange  assistants,  and  for  these  and  other 
obvious  reasons  can  not  do  himself  and  his  patient  jus- 


TKAVEL   AS   A    ^FEDLCAL    EDUCATION.  17 

tice.  The  traveling  post-graduate  medical  student,  un- 
les;?  he  intends  to  devote  considerable  time  to  labora- 
tory work,  should  not  remain  at  any  one  place  for  any 
length  of  time.  It  does  not  take  long  to  become  fa- 
miliar with  methods  of  teaching  and  details  of  operative 
technic.  It  is  more  profitable,  and  certainly  more  inter- 
esting, to  see  ten  men  operate  ten  times  each  than  to 
see  any  one  man  operate  a  hundred  times.  Travel,  as 
a  means  of  post-graduate  medical  education,  does  not 
necessarily  imply  that  the  time  should  be  spent  in  great 
medical  centers,  as  is  too  often  the  case.  Some  of  the 
very  best  medical  and  surgical  work  is  now  being  done 
beyond  the  shadows  of  medical  schools  and  great  met- 
ropolitan hospitals.  We  often  learn  more  of  the  real 
merit  of  a  surgeon  who  is  thrown  entirely  on  his  own  re- 
sources in  some  remote,  small,  isolated  city,  whose  in- 
strument supply  is  limited,  assistants  few  and  perhaps 
inexperienced,  than  when  we  witness  the  operations  by 
recognized  masters  in  the  palatial  hospitals,  supplied 
with  everything  that  modern  surgery  could  possibly  sug- 
gest, and  assisted  by  a  large  staff  of  well-trained,  ex- 
perienced resident  surgeons. 

In  our  country  and  abroad  magnificent  little  hospi- 
tals are  being  built  in  the  smaller  cities  and  large  vil- 
lages in  which  the  patients  receive  excellent  nursing 
and  the  very  best  medical  and  surgical  service.  Some 
of  these  places  in  our  own  country  have  recently  become 
famous  for  the  excellency  of  the  surgery  practiced. 
Among  these  Eochester,  Minn.,  and  Oshkosh.  Wis.,  de- 
serve special  mention.  The  Mayo  brothers  at  Rochester 
control  the  lion's  share  of  the  surg-ery  of  the  West,  and 
their  hospital  in  the  little  prairie  city  of  not  more 
than  5,000  inhabitants  has  become  a  Mecca  for  the  sur- 
geons not  only  from  this  country  but  from  al^road. 
There  is  no  other  hospital  on  this  side  of  the  Atlantic 
in  which  so  many  important  operations  are  performed 
daily  as  in  this  one.  It  would  be  difficult  for  any  one 
to  visit  St.  Mary's  Plospital.  Oshkosh,  a  city  of  30,000 


18  AROUND    THE    WOItLl)    VIA    INDIA. 

inhabitants,  in  which  Dr.  C.  W.  Oviatt  does  his  surgi- 
cal and  gynecologic  work,  and  find  him  perform  less 
than  three  or  four  major  operations,  any  day  of  the 
year.  These  are  by  no  means  isolated  instances;  there 
are  many  other  comparatively  small  cities  in  which  the 
traveling  physician  will  find  excellent  physicians  and 
surgeons  from  whose  example  and  practice  he  will  carry 
away  many  new  ideas,  suggestions  and  hints  of  scientific 
and  practical  importance.  The  clinical  teacher  is  not 
necessaril}^  the  best  physician  or  surgeon,  as  much  of  his 
time  and  talent  are  consumed  for  the  benefit  of  his  stu- 
dents. It  is  the  man  with  a  solid,  scientific  foundation, 
endowed  with  a  keen,  practical  sense,  studious  and  de- 
voted to  his  work,  who  generally  scores  the  greatest  suc- 
cess. Travel  from  place  to  place  has  this  one  great 
advantage,  that  the  traveler  does  not  become  one-sided 
nor  too  mucli  influenced  by  the  views  and  practice  of 
any  one  man.  The  traveler  must  know  hoAv  to  discrim- 
inate, what  to  reject  and  what  to  adopt.  We  often  learn 
more  from  shadows  than  light  and  from  niistakes  than 
a  correct  tcchnic.  The  privileged  visitor  must  be  slow 
in  criticism  and  grateful  for  the  opportunities  he  is 
given  to  familiarize  himself  with  methods  employed  by 
men  in  various  parts  of  the  world.  Let  him  travel  from 
place  to  place,  cultivate  the  personal  acquaintance  of  his 
professional  colleagues  near  and  far  and  learn  from 
them  all  lie  can  and  remember  tliat 

"The  use  of  traA'eling  is  to  regulate  the  imagina- 
tion by  reality,  and  instead  of  thinking  how 
things  may  be,  to  see  them  as  they  are." — Tohnson. 

Many  men  with  lirilliant  minds  and  endowed  with 
the  purest  and  noblest  ambitions  to  succeed  in  their 
calling  fail  in  reaching  the  intended  mark  because  they 
did  not  keep  in  touch  with  the  outside  world.-  Tn  the 
practice  of  medicine  isolation  is  a  dangerous  thing  be- 
cause it  engenders  a  routine  practice  from  which  it  is 
impossible  to  escape  in  late  attempts.  The  observation 
of"  tlie  work  of  others,  the  interchans-e  of  ideas  and  ex- 


TI!AVi:i.    AS   A   MEDICAL    I^DUCATION".  19 

periences  constitute  a  course  of  post-graduate  education 
which  can  not  be  supplanted  by  the  greatest  diligence 
in  reading  and  hard  laboratory  work.  The  young  doc- 
tor should  take  short  vacations,  and  with  advancing  age 
the  length  of  vacations  and  scope  of  travel  should  in- 
crease. Away  from  trouble,  free  from  care,  tlie  wander- 
ing })liysician  will  find  between  his  hospital  visits,  lab- 
oratory investigations  and  museum  studies  most  profit- 
able opportunities  to  dip  deep  into  the  great  and  inex- 
haustible book  of  nature.  I  can  hardly  conceive  of  a 
])hysieian  who  loves  and  values  his  profession  who 
should  not  take  the  deepest  interest  in  medical  geog- 
raphy and  cver3-thing  that  pertains  to  it.  The  physi- 
cian can  not  help  making  man,  under  the  most  varying 
conditions,  climatic  and  social,  a  life  study.  He  can 
not  resist  the  allurements  of  the  vegetable  and  animal 
kingdom  imder  most  diverse  conditions  of  climate  and 
soil.  Away  from  the  bedside  and  operating  room,  out 
of  reach  of  the  moaning,  of  the  suffering  and-  the  anx- 
ious faces  of  the  parents  and  friends  of  the  afflicted, 
he  will  instinctively  turn  to  the  more  pleasant  phases 
of  life  and  study  and  admire  the  wonderful  works  of 
the  Supreme  Creator  of  all  things,  animate  and  inani- 
mate. Awa}^  from  toil  the  sun  will  appear  to  him 
brighter,  the  stars  nearer  and  more  brilliant,  the  flow- 
ers more  beautiful,  the  foliage  and  sward  greener,  the 
song  of  lairds  more  cheerful,  the  babbling  of  brooks  more 
gentle  and  the  language  of  the  talking  ocean  sweeter 
than  when  eye  and  ear  are  engaged  by  the  afflictions 
of  his  suffering  clientele.  Let  the  overburdened,  care- 
worn physician  remember  wOien  away  from  care  and 
anxiety 

"We  place  a  happy  life  in  tranquility  of  mind." 
— Cicero. 
San  Francisco,  Jiilv  7,  1904. 


LEPROSY  IN  THE  HAW  Al  J  AX  ISLANDS. 


THE   PROPOSED  ESTABIJSHMEXT   OF  A  GOVERXMENT   BAC- 
TERIOLOGIC    INSTITUTE. 

The  inhabitants  of  the  beautiful  Hawaiian  Islands, 
comparatively  free  from  the  devastating  infectious  dis- 
eases so  long  as  they  enjo^-ed  the  blessings  of  isolation 
from  the  outside  world,  have  been  made  painfull}^  aware 
of  the  dangers  of  the  dissemination  of  disease  from 
man  to  man.  They  have  experienced  the  benefits  and 
blessings  as  well  as  the  evils  and  curses  arising  to  them 
from  a  new  civilization  brought  to  their  palm-clad 
shores  by  white  men  in  search  of  new  lands  and  fabu- 
lous wealth.  Some  fifty  years  ago  the  first  case  of  lep- 
rosy came  to  the  little  island  kingdom  from  the  distant 
Orient.  As  usual  with  the  primitive  peoples  of  the 
islands  of  the  South  Seas,  this  dreadful  disease  found 
a  fertile  soil  in  the  natives,  with  so  little  resistance  to 
all  infectious  diseases,  acute  or  chronic.  It  spread  with 
alarming  rapidity,  and  it  became  evident  unless  rigid 
measures  were  enforced  in  the  way  of  absolute  and 
early  segregation,  that  fi'om  this  cause  alone,  the  entire 
population  would  become  practically  extinct  in  less  than 
half  a  century.  In  1866  the  number  of  known  lepers 
had  reached  105;  in  1876,  677;  in  1886,  590;  in  1897, 
1.100,  and  when  I  visited  the  Molokai  settlement  two 
years  later  I  found  that  the  number  of  leper-^  had 
reached  1,300.  When  I  visited  the  islands  a  «econd 
time  I  was  informed  that  the  number  of  lepers,  owing 
to  the  fearful  mortality  among  them,  had  been  reduced 
to  1,100.  The  nationalities  of  the  lepers  is  shown  by 
a  report  made  in  1898,  of  which  number  981  were  na- 
tives, 63  half  castes.  3?  Chinese,  and  5  Americans. 


22  AROUND    THE    WOELD    VIA    INDIA. 

SEGKEGATION. 

When  it  was  found  necessary  to  enforce  segregation 
a  commission  was  appointed  to  select  the  most  favor- 
able location,  climatic  and  otherwise,  for  the  unfor- 
tunate exiles.  This  commission  acted  wisely  in  select- 
ing a  tongue-like  projection  of  the  island  of  Molokai, 
isolated  on  t.wo  sides  by  the  ocean  and  from  the  re- 
maining part  of  the  island  by  an  almost  perpendicular 
cliff,  the  Pali,  2,000  feet  in  height,  which  is  crossed 
by  those  who  are  permitted  to  visit  the  settlement  over 
a  shelf-like  path  hewn  out  of  the  solid  rock.  A  trip 
over  such  a  mountain  path  demands  much  physical  ex- 
ertion, and  more  than  an  ordinary  interest  in  making 
the  visit.  The  laws  regulating  and  enforcing  segrega- 
tion are  more  stringent  here  than  anywhere  else.  They 
include  a  divorce  of  married  people  if  the  man  or  wife 
so  desire,  and  exclusion  from  society  for  the  remainder 
of  the  leper's  life.  If  the  healthy  husband  or  wife  is 
willing  to  share  the  fate  of  the  doomed  consort  she  or 
he  is  permitted  to  share  the  banishment,  with  the  un- 
derstanding that  the  exile  is  for  life,  and  with  no  ex- 
pectation of  ever  coming  in  touch  with  remaining  rela- 
tives again,  this  side  of  eternity.  On  the  other  hand, 
the  exiled  man  or  woman  is  free  to  marry  again,  an 
inmate  of  the  leper  settlement.  The  government  recog- 
nized that  what  certainly  appear  as  hard,  and  even 
cruel,  measures,  were  intended  for  the  benefit  and  pro- 
tection of  the  mass  of  the  population.  That  these  se- 
vere laws  met  first  with  violent  opposition  on  the  part 
of  the  lepers  and  their  devoted  relatives  and  friends 
is  very  natural,  among  a  people  who  are  very  unselfish 
and  affectionate.  The  officers  were  intrusted  with  car- 
rying the  laws  into  effect.  The  physicians  who  made 
the  diagnosis  and  the  police  who  had  to  apprehend  the 
suspects  and  attend  to  their  transportation  to  the  settle- 
ment met  with  many  difficulties,  and  in  some  instances 
sustained  personal  violence. 


Fi«.    n. — Tiiberctilar    Ippmsy    in    a    yoiinj;    native    girl. 


24 


AlfOUXD    THE    WOULD    VIA    INDIA. 


A   FIGHTING   LEPER. 

There  is  one  instance  on  record  where  a  leper  resisted 
not  only  the  police  force  but  an  entire  company  of  in- 
fantry. He  hid  himself  in  a  mountain  cave,  accom- 
panied l)y  hi-  faithful  wife,  the  only  access  to  which 
was  ovci'  a  narrow  patli,  whore  incu  liad  to  walk  in  sin- 


Fig.   2. — Tubercular   leprosy   in  a   Hawaiian. 


glo  file.  He  supplied  himself  with  firearms  and  ample 
ammunition,  and  declared  that  anyone  who  caine  within 
range  of  his  gun  would  be  killed.  When  the  soldiers 
were  sent  to  secure  him  he  only  did  what  he  had  threat- 
ened, and  killed  the  first  four  who  headed  the  file.  The 
attempt  was  never  repeated,  and  the  desperate  leper  had 
the  satisfaction  of  being  relieved  of  sufferings   in  his 


I1A\\A1JA^'    ISLANDS.  35 

lonely  cave,  beiiii;'  eared  i'ov  hy  lii.-  devoted  wil'e.  .lust 
when  lie  died  and  where  his  mutilated  body  found  its 
last  resting  place  no  one  knows,  as  his  wife  took  the 
precaution  to  hide  his  remains  in  some  lonely  mountain 
phice,  to  protect  it  from  being  interfered  with,  and  h.er 
efforts,  so  far,  have  been  successful. 

THE    LEPER    SETTLEMENT    ON    THE    ISLAND    OF    MOLOKAI. 

The  leper  settlement  is  made  up  of  two  villages,  on 
opposite  sides  of  the  promontory.  From  the  very  be- 
ginning the  unfortunate  inhabitants  of  this  strange 
and  ideal  settlement  have  been  treated  in  the  kindest 
and  most  humane  manner.     Under  royal  rule,  when  the 


^n 

t~" " ■"■"■«■■■ 

H 

-i 

J 

-   MOLOKAI 

,|U| 

m^^^j^t^j^wjw^im 

iJ^I 

Fig.    3. — Island   of  Molokai. 

islands  formed  a  republic,  and  now  under  a  territorial 
form  of  government,  large  sums  of  moneA^  on  an  aver- 
age $100,000  a  year,  have  been  spent  to  procure  all  pos- 
sible comfort.  The  settlement  has  churches,  school- 
houses,  stores,  and  even  places  of  amusement.  The 
lepers  live  in  little  homes,  to  many  of  which  a  pleasant 
garden  spot  is  attached.  This  parental  care  on  the  part 
of  the  government,  and  the  home  life  are  what  have 
removed  all  opposition  to  segregation.  Lepers  now  seek 
admission  to  the  settlement  of  their  own  accord.  It 
would  be  difficult,  and.  I  think,  impossible  to  find  a 
place  better  adapted  by  nature  for  such  a  purpose.  The 
equable  climate  all  the  year  around,  the  cooling,  re- 
freshing land  and  sea  breezes,  the  snrf  baths,  the  abuud- 


26  AROUXD    THE    WORLD    VIA    INDIA. 

ance  of  salt-water  fish,  the  excellent  water  supply  and 
natm-al  seweraoe  advantages  furnish  C(nnforts  and  con- 
ditions, by  nature  and  man,  that  could  not  be  found 
anywhere  else. 

A    GOVERNMENT    BACTERIOLOGIC    LABORATORY    AND    STA- 
TION  FOR   THE   SCIENTIFIC    STUDY   OF   LEPROSY". 

The  government  owes  an  important  duty  in  furnish- 
ing protection  to  its  citizens  against  infectious  diseases. 
To  the  physician  lej)rosy  still  remains  a  strange,  mys- 
terious disease.  Wo  know  its  microbic  cause,  we  have 
become  somewhat  familiar  with  its  pathology,  we  are 
powerless  in  curing  it,  or  even  in  retarding  its  ravages 
and  relentless  course.  A  successful  treatment  must 
and  will  be  found.  There  is  no  other  place  in  the  world 
where  more  effective  work  could  be  done.  The  lepers 
are  here.  They  are  a  docile,  gentle  people,  who  will 
heartily  co-operate  with  a  scientific  man  to  find  the 
much-needed  remedy.  The  annexation  of  the  Hawaiian 
Island  places  this  great  field  of  scientific  reseaicli  within 
easy  reach  of  the  United  States.  Little  Japan  has 
placed  a  small  colony  of  lepers  and  sufficient  funds  at 
the  disposition  of  the  distinguished  Professor  Kitasato 
to  discover  a  remedy  for  millions  of  people  scattered 
all  over  the  world.  Why  can  not  the  rich  and  enter- 
prising government  of  the  United  States  embrace  this 
great  opportunity  to  find  a  remedy  for  such  a  loathsome 
and  hopeless  disease  like  lepra.  With  the  acquisition 
of  island  possessions  in  the  Pacific  and  Atlantic  the 
danger  of  the  spread  of  the  disease  in  our  own  country 
is  being  vastly  increased.  Let  the  United  States  take 
care  of  the  leper  settlement  at  Molokai,  spend  $100,000 
in  tlie  erection  of  a  laboratory  for  the  study  of  leprosy, 
pay  a  recognized  scientist  at  its  head  with  a  salary  of 
$10,000  a  year,  and  thus  place  itself  in  line  with  other 
countries,  which  are  now  doing  what  they  can  on  a 
much  smaller  scale  in  bringing  leprosy  within  range  as 
a  curable  disease.     Hawaii  would  hail  such  a  step  with 


HAWAIIAN     ISLANDS. 


27 


jov.  to  1)1'  relicNcd  oT  the  lic;i\\  annual  expense  iu  ciir- 
ing  for  its  leper  children,  and  in  co-operating  with  the 
general  government  in  scientitic  research,  calculated  to 
lead  to  the  discovery  of  a  cure  for  a  disease. so  widely 
spread,  and  which  lias  proved  itself  so  obstinate  to  all 
kinds    of    treatment    so    far    suggested    and    tried,    and 


Fig.    4. — Anesthetic   leprosy   in   a   native   woman. 


against  the  dissemination  of  which  stern  exile  has  been 
the  only  means.  The  time  is  ripe  for  the  United  States 
to  act.  Let  the  mass  of  the  American  medical  profes- 
sion agitate  this  matter  and  let  the  delegates  of  the 
territory  bring  it  to  the  attention  of  our  energetic  and 
humane  congress  and  such  prompt  action  is  sure  to 
bring  about  the  desired  result. 


38 


AKOUXD    THE    WORLD    VIA    INDIA. 


THE    ISLAND   OF   MOLOKAI    AS   A    HOME    FOR   LEPERS. 

As  can  be  seen  from  the  accompanying  small  sketch 
of  the  island  of  Molokai  (Fig.  3)^,  the  leper  settlement 
occupies  only  a  very  little  of  it.  It  seems  to  me  that  in 
view  of  the  many  lepers  that  will  come  under  our 
charge  it  might  be  advisable  to  devote  the  whole  island 
of  Molokai  to  homes  for  lepers.  There  is  only  one  lim- 
ited tract  of  land,  owned  by  Mrs.  Meyer  and  her  chil- 
dren, which  is  of  any  considerable  money  value.  The 
balance  of  the  island  could  bo  bonglit  very  cboaply.    The 


Fig.  5. — Baldwin  Home  for  leper  boys,  Kalawao,  Molokai. 

Hawaiian  lepers  should  remain  where  they  are,  but  the 
remaining  part  of  the  island  could  be  readily  converted 
into  pleasant  homes  for  lepers  from  the  states  and  colo- 
nies. The  entire  island  is  large  enough  for  colonies 
representing  different  nationalities,  which  could  be  es- 
tablished sufficiently  far  apart  to  guard  against  interna- 
tional friction.  It  would  not  be  difficult  to  locate  pleas- 
antly 3.000  additional  lepers  on  the  opposite  shore  and 
mountainous  part  of  the  island.  This  suggestion  is 
worthv  of  consideration.  Hoxohlx-.  Julv  U.  in04. 


FATHEK  DAMiEN,  THE  LEPER  HEEO. 

"Ni>tliiug   is   more   (lflij;litfiil   than   the   light   of 
truth. " — t'iccio. 

There  arc  heroes  and  heroines,  men  and  women,  who 
in  times  of  danger  do  not  hesitate  to  sacrifice  their 
lives  in  attempts  to  save  others.  Heroism  consists  in 
acts  of  unselfishness  and  courage  of  the  highest  type, 
imder  conditions  of  impending  danger,  or  calling  for  a 
degree  of  self-sacrifice  from  which  the  average  mortal 
instinctively  shrinks.  Untimely  death  and  self -impose  J 
deprivation  of  the  comforts  of  life  for  the  benefit  of 
others  who  are  in  danger  or  distress  exact  from  heroes 
the  highest  and  noblest  qualities  of  man — undaunted 
courage,  unselfish  charity  and  unconquerable  love,  and 
boundless  humanity  toward  mankind.  Such  a  combi- 
nation of  the  highest  virtues  is,  indeed,  rare,  and  when 
fomid  entitles  the  hero  to  the  profound  respect,  highest 
admiration  and  jx'i  nianent  gratitude  of  all  nations,  and 
more  especially  the  one  benefited  by  his  sacrifices.  The 
world  looks  to  the  battlefield  as  the  arena  for  the  exhi- 
bition of  heroism  in  its  truest,  grandest  and  noblest 
sense.  Military  heroism  has  from  time  immemorial 
been  immortalized  in  song  and  prose.  Heroism  in  war 
signifies  courage  and  patriotism,  but  lacks  humanity 
and  the  greatest  of  all  virtues,  charity.  The  soldier 
knows  that  his  bravery  will  be  recognized,  and  that,  in 
tlie  event  of  his  survival,  he  may  confidently  expect 
that  a  grateful  nation  will  reward  him  for  his  valiant 
services. 

Sudden,  painless  death  in  the  heat  and  tumult  of 
battle  is.  in  itself,  an  honor,  a  sufficient  inducement 
for  many  to  seek  it  when  imbued  with  the  justness  of 
the  cause  for  which  they  fight  and  stimulated  bv  the 
fire  of  a  burning  patriotism.     Heroism  in  tlio  cause  of 


30  AROUND    THE    AVOItLD    VIA    IKDIA. 

humanity,  stripped  of  the  excitement  and  glories  of 
war,  brings  out  the  best  attributes  of  man.  Heroism 
rendered  at  the  altar  of  humanity,  with  no  expectation 
of  renown  or  reward,  among  the  sick  and  dying,  under 
conditions  attended  by  vastly  more  danger  to  life  and 
health  than  the  risks  of  war,  gives  testimony  of  the 
highest  type  of  a  hero  or  heroine. 

Such  a  hero  was  Father  Damien,  the  subject  of  this 
sketch.  During  his  life  devoted  to  the  welfare  of  exiled 
lepers,  his  motives  were  often  misunderstood  and  his 
noble  soul  experienced  many  a  pang  when  he  was  ma- 
ligned, as  was  not  infrequently  the  case.  We  can  say 
of  him  : 

"Glory   comes   too  late    when   paid  only   to   our 
ashes." — Martialis. 

Father  Damien  is  no  stranger  to  the  medical  profes- 
sion (Fig.  ()).  His  heroic  labors  among  the  banished, 
maimed  and  disfigured  lepers  of  Molokai,  and  his  glori- 
ous death  from  the  disease  he  fought  so  courageously, 
have  made  him  a  hero  in  the  estimation  of  the  medical 
profession  and  in  the  eyes  of  the  entire  world — a  hero 
whose  name  will  live  long  after  the  disease  he  fought 
and  from  which  he  died  will  have  become  extinct.  As 
a  humanitarian,  his  memory  will  go  down  to  the  future 
side  by  side  with  that  of  Henri  Dumont;  as  the  leper 
hero,  it  will  never  die.  The  whole  life  of  Father  Da- 
mien from  the  cradle  to  the  grave  was  an  exemplary 
one.  and  his  work  was  characterized  by  unselfislmess 
and  an  ardent  devotion  to  his  manifold  and  trying 
duties.  How  it  was  possible  that  statements  to  the 
contrary  could  have  been  made  during  his  lifetime  is 
a  mystery  that  admits  only  of  one  explanation — ^he,  like 
other  great  men,  had  enemies  whose  envy  was  aroused 
by  the  marvelous  success  in  everything  he  attempted. 
His  entire  career  as  a  priest  and  friend  of  the  lepers 
breathes  a  spirit  of  true,  earnest  Christianity  which 
those  who  know  him  best  never  questioned.  The  ma- 
licious attacks  on  his  character  were  made  bv  men  who 


Fig.  6. — Fr.  Damien  de  Veuster,  at  33  years  of  age,  when  start- 
ing   for    the    leper    settlement.  * 


HAWAIIAN    ISLANDS.  33 

were  too  cowardly  to  visit  the  leper  settlement  and  ob- 
serve his  Work  among  the  thousand  unfortunates  whose 
pains  he  soothed  and  to  whose  spiritual  needs  he  min- 
istered with  an  unparalleled  zeal  and  untiring  devotion, 
whose  dying  he  consoled,  and  whose  dead  he  buried  in 
coffins  and  graves  often  made  by  his  own  hands.  As  a 
true  ininister  of  the  gospel,  he  served  his  God  and  lep- 
rous congregation  with  a  devotion  and  faithfulness  that 
knew  no  limits,  by  day  and  night,  in  sunshine  and 
storm. 

Father  Damien's  name  in  the  w^orld  was  Joseph  de 
Veuster.     He  was  born  at  Tremelo,  near  Louvain.  Bel- 
gium, Jan.  3,   1840.     His  parents  were  honest,  hard- 
working, devout  peasants,  who  raised  a  family  of  seven 
children,    four    of    whom    entered    the    service    of    the 
church — his  older  brother,   Pamphile,  and  two  sisters. 
The  earliest  desire  of  his  boyhood  was  to   become   a 
priest,   in   which   vocation   his   older  brother   preceded 
him.     The  parents  being  poor,  he  struggled  with  the 
greatest  difficulties  to  realize  his  desire.     He  finally  en- 
tered the  College  of  the  Fathers  of  the  Sacred  Hearts 
of  Jesus  and  Mary,  and  entered  holy  orders  at  the  age 
of  19.     The  splendid  health  which  he  enjoyed  through- 
out his  long  student  life  was  gained  during  his  boy- 
hood days,  spent  in  hard  work  on  the  farm.     The  clois- 
ter life  made  him  abstemious,  and  he  exhibited  an  irre- 
sistible  attraction   for   the   rigors   of   austere    penance. 
Early  piety  and  a  tender  affection  for  his  parents,  as 
shown  in  all  his  letters,  laid  the  foundation  for  a  suc- 
cessful priestly  career.     When  he  entered   the  cloister 
he  was  the  very  embodiment  of  health,   strength   and 
activity.     Endowed  with  great  mental   poAver  and  ap- 
plying himself  closely  to  his  studies,  his  progress  was 
rapid,   and  when  he   left  the   institution   he   was   well 
prepared  for  his  chosen  life  work.     Although  serious, 
he  was  not  ascetic.     In  a  letter  to  his  parents  during 
his  theological   studies,  in   commenting  on  the  uncer- 
taintv  of  life,  he  says:     "The  thought  of  the   uncer- 


34  AUOUXD    TILE    WORLD    VIA    INDIA. 

tainty  of  to-morrow  must,  no  doubt,  cause  bitter  grief 
to  a  sinful  soul,  but  for  us,  Christians  or  religious,  who 
look  on  ourselves  as  exiles  here  below,  and  who  long 
only   for   dissolution   of   our   body  that  we   may   enter 
our  true  country,  there  is,  it  appears  to  me,  only  joy 
and  blessedness  in  the  thought  that  each  moment  we 
get  nearer  to  the  last  hours  of  our  life."     Hi?  splendid 
health,  his  love  for  an  abstemious  life,  and  especially  his 
burning  desire  to  serve  his  Lord  and  his  church  where 
he  could  accomplish  the  most,  awakened  in  him   dur- 
ing his  early  novitiate  days  an  ardent  desire  to  conse- 
crate himself  to  missionary  work  in  the  islands  of  the 
Pacific.     I  have  no  doubt  but  that  this  desire  was  often 
included   in   his    daily   prayers.      The   prayer   was   an- 
swered sooner  than  he  possibly  could  expect.    Mgr.  Mai- 
gret,  vicar-apostolic  of  the  Hawaiian  Islands,  made  a 
request  for   sisters   and  brothers  to   assist  him   in   his 
missionary  work.     His  brother,  Pamphile,  was  selected, 
but  took  typhoid  fever,  and  Damien  begged  to  take  his 
place.     He  was  then  only  in  minor  orders,  but  the  re- 
quest was  granted.     What  a  source  of  pleasure  it  must 
have  been  for  young  Damien  to  learn  that  he  was  per- 
mitted to  enter  on  work  in  one  of  the  roughest  of  the 
Lord's  vineyards  so  early  in  life  I      He  made  the  long 
journey  in  a  sailing  vessel  from  Bremen  to  Honolulu 
around   Cape   Horn,   and  was   ordained   priest   on  his 
arrival,    at  the   age   of   24.      On   foot   and   horseback, 
across  mountain?  and  vallej^s,  from  place  to  place,  he 
brought  to  the  natives  the  glad  tidings  of  the  gospel, 
and  by  his  great  modesty,  genial  manners  and  a  will- 
ingness  to   assist   them   in   their   worldly   affairs,   soon 
won   their    confidence,    respect   and    love.      The   name 
Kamiano,  the  Hawaiian   for  Damien,   soon  became  a 
household  word  throughout  the  islands.     His  first  sta- 
tion as  priest  was  in  Hawaii  Island,  but  it  was  destined 
that  his  life  should  be  sacrificed  in  the  spiritual  and 
worldly  betterment  of  the  imfortunate   inhabitants  of 
the  leper  settlement.     Before  Father  Damien  came  to 


HAW  A11.VX    ISLANDS.  35 

the  settleiiic'iit  the  government,  after  establishing  seg- 
regation, only  concerned  itself  in  the  temporal  well- 
beinff  of  the  unfortunate  outcasts.  The  manv  Protes- 
tant  ministers  in  the  islands  never  dreamed  of  extend- 
ing their  work  to  where  it  was  most  needed.  The 
Catholic  Church,  ever  alert  to  enlarge  its  field  of  use- 
fulness, and  to  reach  the  poor,  miserable  and  unfor- 
tunate, and  liring  them  within  its  fold,  came  to  tlie 
rescue  of  the  leper  outcasts.  Occasional  visits  to  the 
settlement  to  render  the  much-needed  spiritual  assist- 


Fig.  7. —  Kalawao  leper  settlement.  Molokai,  established  b3-  the 
Hawaiian  government  in  1S65,  showing  also  Father  Damien's 
church. 

ance  were  made  by  Fathers  Kaymund,  Albert  and  Bono- 
face  from  1871  to  1873.  A  lay  brother  completed  a 
little  church  in  1873.  At  a  meeting  of  priests  held  at 
this  time  in  Maui,  presided  over  by  the  bishop,  it  was 
decided  to  supply  the  settlement  with  a  resident  priest. 
The  bishop  called  for  a  volunteer.  Every  one  of  the 
three  priests  assembled  was  ready  to  serve. 

Father  Damien  emphasized  his  claim  for  preference 
in  the  following  brief,  forcible  speech :     ''My  Lord,  re- 


3G  ai{ou>;d  the  wokld  via  india, 

memberiiig  that  I  was  jDlaced  under  the  pall  on  the 
da}'  of  my  religious  profession,  thereby  to  learn  that 
voluntary  death  is  the  beginning  of  a  new  life,  here  I 
am,  ready  to  bury  myself  alive  among  these  unfor- 
tunate people,  several  of  whom  are  personally  Icnown 
to  me."  Such  language  could  not  fail  in  securing 
for  him  the  cherished  position.  He  sailed  directly  for 
the  settlement,  where  he  landed  May  10,  1873,  penni- 
less, and  even  without  a  change  of  linen.  The  only 
available  shelter  he  found  to  protect  him  from  rain  and 
the  burning  rays  of  the  sun  was  a  hospitable  pandanus 
tree,  in  the  shadow  of  which  he  lived  for  some  time. 
The  very  presence  of  this  saintly  priest  had  of  itself 
a  marvelous  effect  on  the  morals  of  the  exiled.  In  a 
letter  to  his  provincial  two  days  after  reaching  the  set- 
tlement he  writes:  "You  know  my  disi^osition.  I 
want  to  sacrifice  myself  for  the  poor  lepers.  The  har- 
vest is  ripe."  The  heroism  of  this  humble  priest  made 
a  deep  impression  not  only  on  the  lepers,  but  the  en- 
tire population  of  the  islands.  He  commenced  work 
with  a  will.  The  time  left  between  his  priestly  offices 
Avas  occupied  in  improving  the  worldly  condition  of  his 
charges.  Beside  his  clerical  duties,  he  did  the  work  of 
a  carpenter,  mason,  gardener,  etc.  It  is  said  that  he 
made  more  than  1,500  coffins  for  his  dead  out  of  the 
rough  boards  furnished  by  the  government.  On  an 
average  he  officiated  at  200  funerals  a  year,  where  he 
often  was  priest  and  sexton  at  the  same  time. 

He  built  little  frame  houses  among  them — one  for 
himself,  Avith  only  tAvo  small  rooms.  I  found  here  a 
Avooden  bathtub  made  by  himself  which  gave  testimony 
to  his  skill  as  a  carpenter.  No  leper  CA^er  entered  this, 
the  plainest  of  all  houses  in  the  village.  A  chair,  table, 
bed  and  a  fcAV  plain  pictures  representing  Bible  scenes 
and  the  life  of  saints,  his  saddle  and  bridle,  well  worn, 
and  a  foAv  religious  books  Avere  about  CA^erything  he  left 
behind  him  at  the  time  of  his  death.  He  built  an- 
other cliurch  (Fig.  3),  doing  most  of  the  Avork  himself. 


1  LAW  A  I  IAN      |SLAMJ.>. 


;J7 


and  took  great  pleasure  in  rendering  its  interior  at- 
tractive by  the  simplest  but  tasty  decorations.  He 
erected  schoolhouses  and  orphan  asylums,  established 
a  choir  and  organized  a  music  band,  and  placed  them 
under  the  direction  of  his  faithful  helper,  Brother  But- 
ton. I  listened  to  tlie  music  of  this  band  playing  na- 
tional and  sacred  songs.  Every  member  of  the  band 
was  a  leper;  some  had  lost  a  number  of  their  fingers, 
others  played  the  cornet  with  lips  half  destroyed,  ulcer- 
ated and  distorted.  It  was  a  scene  it  would  be  impossi- 
ble to  forget.  Father  Damien  became  a  physician  and 
a  druggist,  and  his  place  in  these  functions  is  now 
filled  by  Brother  Button.  Although  the  settlement  had 
a  resident  physician  at  the  time  of  my  visit,  the  little 
but  well-stocked  dispensary  was  crowded  with  patients, 
and  Brother  Button  was  busy  in  washing  and  dress- 
ing wounds  and  dealing  out  simple  remedies. 

In  describing  leprosy.  Father  Bamien  writes  to  his 
brother:  "Leprosy,  so  far  as  is  known,  is  incurable. 
It  seems  to  begin  by  a  corruption  of  the  blood.  Bis- 
colored  patches  appear  on  the  skin,  especially  on  the 
cheeks,  and  the  parts  affected  lose  their,  feeling.  After 
a  time  this  discoloration  covers  the  whole  body;  these 
ulcers  begin  to  open  chiefly  at  the  extremities.  The 
flesh  is  eaten  away  and  gives  out  a  fetid  odor;  even  the 
breath  of  the  leper  becomes  so  foul  that  the  air  around 
is  poisoned  with  it.  I  have  had  great  difficulty  in  get- 
ting accustomed  to  such  an  atmosphere.  One  day  at 
the  Sunday  mass  I  found  myself  so  stifled  that  I 
thought  I  must  leave  the  altar  to  breathe  a  little  of  the 
outer  air,  but  I  restrained  myself,  thinking  of  our 
Lord  when  He  commanded  them  to  open  the  grave 
of  Lazarus,  notwithstanding  Martha's  word,  'Jam 
foetetf  Now  my  sense  of  smell  does  not  cause  me  so 
much  inconvenience,  and  I  enter  the  huts  of  lepers 
without  difficulty.  Sometimes,  indeed,  I  feel  some  re- 
pugnance when  I  have  to  hear  the  confessions  of  those 
near  the  end,  whose  wounds  are  full  of  masrgots.    Often. 


38  AHOUXD    THE    WORLD    VIA    INDIA. 

also,  I  scarce  know  how  to  administer  extreme  ^^nction, 
when  both  hands  and  feet  are  nothing  but  raw  wounds." 
Let  those  Protestant  ministers  who  complain  of  small 
salaries  listen  to  how  Father  Damien  managed  his  finan- 
cial affairs :  "I  have  not  a  penny  of  income — yet,  7iihil 
milii  deest.  I  want  for  nothing.  I  have  even  alms  to 
give  away.  How  is  this  to  be  explained?  That  is  His 
secret,  who  promised  to  give  a  hundredfold  to  those 
who  gave  up  all  to  Him."  What  better  proof  could 
be  furnished  of  his  childlike,  Christian  faith?  When 
Father  Damien  took  charge  of  the  leper  settlement  he 
took  a  census  and  found  that  it  contained  600  lepers, 
80  of  whom  were  very  ill  in  the  hospital.  Vice  ran 
high.  The  poor  exiles  sought  solace  in  the  excessive 
use  of  a  domestic  alcohol,  held  dances,  and  practiced 
card  playing  and  sensualities  of  all  kinds.  This  is 
the  way  in  wliich  Father  Damien  proceeded  to  improve 
the  morals  of  the  people:  "Kindness  to  all,  charity  to 
the  needy,  a  sympathizing  hand  to  the  sufferers  and  the 
dying,  in  conjunction  with  a  solid  religious  instruction 
to  my  listeners,  have  been  my  constant  means  to  in- 
troduce moral  habits  among  the  lepers."  It  is  no  won- 
dre  that  under  this  kind  precept  and  teaching  the  in- 
fluence of  Father  Damien  increased  from  day  to  day 
in  improving  the  bodily  and  moral  conditions  of  his 
people.  Protestants,  entirely  neglected  by  their  preach- 
ers, and  non-believers,  soon  felt  the  effect  of  the  relig- 
ious teaching  and  example  of  the  only  spiritual  adviser 
in  the  settlement  and  were  not  slow  in  embracing  the 
Catholic  faith.  This  is  what  one  leper  had  to  say  of 
Father  Damien,  and  he  was  only  the  spokesman  for  all : 
"We  are  especially  satisfied  with  our  pastor.  He  over- 
wholms  us  with  his  solicitous  care,  and  he  himself 
builds  our  houses.  When  any  of  us  is  ill,  he  gives  him 
tea,  biscuits  and  sugar ;  and  to  the  poor  he  gives  clothes. 
He  makes  no  distinction  betAveen  Catholics  and  protes- 
tants."  On  the  occasion  of  a  visit  of  the  princess  regent 
to  the  settlement,  one  of  the  Honolulu  papers,  in  re- 


HAWAIIAN'    ISLANDS.  39 

ferring  to  Father  Damien's  work,  commented  on  it  in 
the  following;-  most  beautiful  language:  "This  young 
priest,  Dainicu  l>y  name,  ulio  has  consecrated  his  life 
to  the  lepers,  is  the  glory  and  boast  of  Hawaii.  He  re- 
suscitates the  saintly  heroism  of  the  bloody  arena  of  the 
ages  of  old — nay,  he  does  even  more.  Would  it  not  be 
a  greater  fa\or  lo  be  thrown  a  prey  to  the  wild  beasts 
rather  than  to  be  condemned  to  live  in  the  poisonons 
atmosphere  of  a  lepor  settlement?  And  Damicn — 
Damien,  the  soldier  of  Christ— has  lived  now  several 
years  in  the  midst  of  the  banished  lepers  of  Molokai !" 
Are  there  any  more  witnesses  to  be  heard  to  prove  that 
the  charges  made  against  Father  Damien  by  a  jealous 
Protestant  minister  who  never  saw  the  leper  settlement 
were  utterly  without  foundation?  T  believe  not,  for 
'Tay  their  fruits  ye  shall  know  them."  The  spiritual 
and  worldly  care  of  the  poor  lepers  remains  to-day  in 
the  hands  of  devoted  priests,  brothers  and  sisters  of  the 
Catholic  Church.  I  could  not  finish  this  brief  sketch 
of  the  leper  hero  without  referring  briefly  to  one  of  his 
faithful  co-laborers  who  shared  with  his  master  the 
heavy  burdens  of  the  early  missionary  work,  and  who 
remain"*   at  his   post   to-day. 

A  HEROIC   BROTHER. 

During  my  visit  to  the  leper  settlement  I  became 
very  much  interested  in  a  man  of  medium  size,  spare 
build,  dressed  in  a  blue  cotton  suit  decidedly  the  worse 
for  long  wear,  a  pair  of  cheap  spectacles  hanging  loosely 
over  nearly  the  end  of  a  sharp-pointed  nose.  He  was 
the  master  of  the  school  for  boys  and  leader  of  the 
band.  His  facial  expression,  bearing  and  attitude  were 
enough  to  indicate  that  he  was  a  tireless  worker.  It 
was  Brother  Dutton,  so  long  associated  with  Father 
Damien  in  the  care  of  the  lepers.  He  showed  us  the 
different  institutions,  and  spoke  most  enthusiastically. 
but  in  great  modesty,  of  his  work.  In  speaking  of 
Father  Damien  tears  filled  his  eyes  and  his  lips  trem- 


40  AKUUXD    THE    WOULD    VIA    IXDIA. 

bled.  He  had  not  visited  the  little  house  in  which 
Father  Damien  lived  since  his  death,  although  separ- 
ated from  his  school  only  by  a  narrow  street.  The 
man's  whole  soul  seemed  to  be  in  his  work,  and  I  pre-. 
sume  the  great  grief  caused  by  the  loss  of  his  beloved 
priest  prevented  him  from  entering  the  little  house 
where  they  had  spent  so  many  hours  together  in  con- 
sultation and  prayer  for  fear  of  increase  of  mental 
anguish.  Nobody  knows  the  early  history  of  his  life. 
He  never  speaks  of  the  past.  It  was  rumored  that  he 
was  disappointed  in  love  during  early  life,  but  no  proof 
to  this  effect  has  ever  been  furnished.  It  is  known  that 
he  served  during  the  civil  war,  and  that  for  gallant 
service  he  was  promoted  from  the  ranks  to  major.  He 
was  a  Protestant,  and  joined  the  Catholic  Church  twen- 
ty-one years  ago,  and  has  been  a  most  devoted  member 
of  that  church  since.  A  friend  has  this  to  say  of  him: 
"His  superb  sacrifice  in  going  to  Molokai  was  made 
from  no  weak  or  unworthy  motive.  He  was  supremely 
grateful  to  Almighty  God  for  the  gift  of  the  true  faith, 
and  simply  wished  to  make  the  best  return  in  his 
power,  and  so,  like  the  brave  soldier  he  had  long  proved 
himself  to  be,  he  quietly  made  the  decision  to  devote 
his  life  to  the  most  laborious  and,  humanly  speaking, 
the  most  distasteful  charity  in  the  whole  range  of  the 
Catholic  religion."  Soon  after  Father  Damien's  death 
Brother  Button  discovered  some  sores  on  his  legs.  He 
firmly  believed  he  was  suffering  from  leprosy,  and  was 
happy  in  the  thought  that  in  a  short  time  he  would 
have  the  great  privilege  to  die  of  the  same  disease 
as  his  master  and  join  him  in  heaven.  The  doctor's 
examination  took  away  this  hope,  and  he  remains  at  his 
post,  free  from  the  loathsome  disease  after  an  uninter- 
rupted service  of  twenty-three  years. 

How  many  faithful,  devoted  and   unselfish   servants 
tlie  Catholic  Church  has! 


HAWAIIAN     I«r.AXI)S. 


41 


THE    LEPER   PRIEST    DIES    OF    LEI'ROSY. 

When  Father  Daniien  left  liis  native  country  lie  bade 
his  relatives  and  friends  good-b^e  with  tha  firm  con- 
viction that  he  would  never  meet  them  again  on  earth. 
When  he  consecrated  himself  to  the  cause  of  the  leper? 
he  did  so  with  the  expectation  that  he  would  sooner  or 
later  share  the  fate  of  his  flock.  It  was  his  desire  and 
hope  that  he  might  be  spared  for  a  long  time  for  the 
benefit  of  the  cause  he  had  made  his  lifework.     He  took 


Fig.  8. — Father  Damieu's  grave. 

every  precaution  to  escape  contagion  by  excluding  the 
lepers  from  his  house  and  by  observing  the  utmost 
cleanliness  of  his  person,  and  by  inculcating  the  same 
as  far  as  he  could  on  the  inhabitants  of  his  leper  vil- 
lages. With  all  care,  however,  he  could  not  escape  the 
unusually  prolific  sources  of  contagion  in  performing 
his  priestly  functions,  more  especially  in  administering 
the  sacrament  and  extreme  unction.  The  manual  labor 
of  the  roughest  kind  which  he  did  for  the  lepers,  to 
make  them  more  comfortable,  could  not  fail  to  produce 


42  AROUND    THE   "WORLD   VIA    INDIA. 

frequently  cuts,  punctures  and  abrasions,  by  which  the 
danger  of  inoculation  was  greatly  increased.  What  he  had 
feared  occurred  before  he  had  expected  it.  After  twelve 
years  of  ceaseless  self-sacrificing  toil  among  the  lepers 
he  discovered  accidentally  that  he  had  himself  become 
a  ^dctim  of  the  terrible  disease.  In  his  sermons  he  al- 
ways addressed  his  congregation,  "We  lepers."  Now  he 
could  say  so  in  truth.  In  taking  a  foot  bath  one  even- 
ing in  hot  water  he  noticed  that  he  had  blistered  one 
of  his  feet  without  having  felt  any  pain.  He  knew 
only  too  well  what  this  meant — ^the  first  symptom  of  the 
anesthetic  form  of  leprosy.  The  physician  who  exam- 
ined him  later  confirmed  what  had  become  to  him  al- 
ready a  conviction.  In  writing  at  this  time  to  the 
bishop,  he  said:  "From  henceforth  I  am  forbidden  to 
come  to  Honolulu  again,  because  I  am  attacked  by  lep- 
rosy. Its  marks  are  seen  on  my  left  cheek  and  ear,  and 
my  eyebrows  begin  to  fall.  I  shall  soon  be  completely 
disfigured.  I  have  no  doubt  whatever  of  the  nature  of 
my  illness,  but  I  am  calm  and  resigned  and  very  happy 
in  the  midst  of  my  people.  The  good  God  knows  what 
is  best  for  my  sanctification.  I  daily  repeat  from  my 
heart,  'Thy  will  be  done.' "  It  was  very  fortunate,  in- 
deed, that  Father  Damien  contracted  the  macular  in- 
stead of  the  tubercular  form  of  the  disease,  and  that  the 
palmer  side  of  fingers  and  hands  remained  clean,  per- 
mitting him  to  perform  his  spiritual  functions  until  a 
few  days  before  his  death,  which  occurred  April  15, 
1889. 

So  ended  the  precious  life  of  one  of  the  greatest 
benefactors  of  the  human  race — the  hero  of  charity  f 
The  greatest  heroism  of  Father  Damien  was  exhibited 
during  his  illness,  as  he  persisted  in  working  with  hand.-4 
and  heart  until  a  few  days  before  his  death.  What 
could  touch  the  human  heart  more  than  to  see  a  leper 
priest  render  manual  work  and  spiritual  consolation  to 
a  congregation  of  lepers,  the  blind  leading  the  blind, 
the  lame  supporting  the  lame!     His  heroic  death  has 


HA"V*A.IIAN    ISLANDS.  43 

silenced  the  vile  tongues.  The  surviving  lepers  can  not 
be  comforted;  they  will  carry  their  grief  over  the  loss 
of  their  faithful  shepherd  to  their  graves.  The  entire 
population  of  the  Hawaiian  Islands — in  fact,  the  whole 
world — mourns  his  death.  He  has  gone  to  his  well- 
earned  reward.  His  mangled  remains  sleep  under  the 
shadows  of  the  pandanus  tree  which  first  sheltered  the 
robust,  devoted  young  priest  awaiting  a  glorious  resur- 
rection.    (Fig.  8.) 

Volumes  have  been  written  in  praise  of  Father  Da- 
mien.  Monuments  have  been  erected  to  his  memory, 
charitable  institutions  have  sprung  up  to  immortalize 
his  heroic  charity ;  but  if  that  humble  priest  could  speak 
to  his  admirers  he  would  say,  "I  have  only  done  my 
duty,  praise  God.  Send  greetings  and  extend  a  helping 
hand  to  my  leper  friends." 

S.  S.  Sierra,  July  18. 


FATHER  DAMIEN. 

O  sing  your  requiems,  waves  and  winds, 

On  far-off  tropic  shore! 
O  mourn  the  Soldier  of  the  Cross, 

Arms  stacked  forevermore! 
The  weapons  forged  in  Love's  fierce  flame 

Of  sacrifice  untold! 
And  shining  with  the  glittering  gems 

Of  abnegation's  gold! 

Dear  Father,  'twas  a  lonely  way, 

Where  waves  moaned  on  the  shore. 
While  with  their  wailings  rose  the  cry 

Of  suffering  evermore. 
Aye,  lonely  as  the  world  defines 

The  loneliness  of  soul, 
But  well  we  know  the  angels  walked 

Beside  thee  to  the  goal! 

Treading  within  the  Savior's  steps, 
And  "doing  all  things  well"; 

Letting  the  light  of  Christian  Hope 
Shine  through  Despair's  dark  cell; 


44  AROUND    THE    AVOELD  WIA    INDIA. 

So  like  thy  Master,  hands  upraised 

To  serve  and  heal  and  bless, 
While  to  His  little  ones  you  gave 

The  Father's  pure  caress. 

Within  that  far-off  tropic  isle 

The  twilight  splendor  glows 
In  dazzling  hues  for  one  brief  space, 

And  then  as  swiftly  goes; 
So  thou  when  life  was  radiant  with 

Thy  splendid  deeds  of  light, 
Saw  deepening  shadows  gather  round 

And  fold  thee  in  Death's  night. 

But  o'er  the  gloom  of  wind-swept  grave, 

A  star  of  beauty  beams. 
And  through  its  rays,  to  all  the  world. 

Thy  martyr's  halo  gleams. 
While  man  remembers  glorious  deeds. 

Thy  name  shall  live  in  light. 
For  never  Soldier  of  the  Cross 

Died  in  a  nobler  fight! 

O  sigh  your  requiems,  ocean  winds, 

Above  the  martyred  one! 
But  clearer  than  your  wailing  rings 

The  Master's  sweet  "Well  done!" 
No  grander,  purer,  nobler  soul, 

E'er  waged  the  war  of  God. 
Sleep  on,  O  Soldier  of  the  Cross, 

Beneath  the  sea-girt  sod! 

^Iary  E.  Griffin. 


MEDICAL  AFFAIES  IN  THE  HAWAIIAN 
ISLANDS. 


The  recent  annexation  of  the  Hawaiian  Islands  as  a 
territoiy  of  the  United  States  has  awakened  among  us 
a  new  interest  in  their  agricultural,  commercial,  pro- 
fessional and  educational  status.  The  wisdom  of  the  con- 
summation of  such  an  act  can  not  be  questioned,  as  the 
United  States  has  thereby  gained  a  firm  foothold  in  the 
Pacific  Ocean  at  a  point  of  great  strategic  importance 
and  the  islands  have  secured  for  themselves  a  permanent 
form  of  government  and  the  most  advantageous  com- 
mercial relations  with  the  outside  world.  The  inhabi- 
tants will  be  made  to  feel  that 

"In  no  other  state  except  that  in  which  the 
power  of  the  people  is  supj-eme  has  liberty  any 
abode,  than  Mhich  nothing  assuredly  can  be  more 
delightful."^Cicero. 

The  islands  have  natural  resources  that  must  be  made 
available  to  the  natives.  The  rapid  transitions  from 
barbarism  to  a  kingdom  and  from  a  kingdom  to  a  re- 
public and  from  a  republic  to  a  territory  of  the  great  re- 
public have  left  the  agricultural  and  commercial  inter- 
ests of  the  islands  in  an  unsettled  state,  which,  however, 
under  the  new  administration  will  soon  be  remedied.. 
Since  the  foreigners  have  taken  the  reins  of  government 
in  their  hands  prosperity  and  depression  have  followed 
each  other  at  variable  intervals  of  time,  and  the  gains 
have  found  their  way  largely  into  the  pockets  of  a  fa- 
vored few.  It  is  to  be  hoped  that  under  the  new  rule 
booms  and  depressions  will  give  way  to  a  steady  and 
more  healthful  growth  of  the  undeveloped  resources  in 
which  the  natives  will  reap  their  legitimate  share. 


46  AROUND   THE    WORLD   VIA    INDIA. 

The  scenic  beauty  of  the  Hawaiian  archipelago  is 
exquisite.  The  islands  are  of  volcanic  origin,  moun- 
tainous, and  clad  with  verdure  and  intersected  by  fertile 
valleys. 

HISTORICAL    SKETCH    OF    THE    ISLANDS. 

It.  is  supposed  that  these  gems  of  the  Pacific  Ocean 
became  populated  by  the  Polynesians  from  the  distant 
Samoa  Islands  about  the  year  500  A.  D.  It  is  claimed 
that  they  were  first  seen  by  Juan  Gaetano,  a  Spanish 
mariner,  in  1555,  but  as  he  left  no  record,  either  at 
home  or  on  the  islands,  of  his  visit  their  discovery  must 
be  credited  to  Captain  Cook,  who  sighted  them  in  Jan- 
uary, 1778,  and  named  them  Sandwich  Islands,  in 
honor  of  Lord  Sandwich.  On  landing,  the  discoverer 
found  them  densely  populated,  the  people  peaceable, 
hospitable  and  extremely  modest  and  courteous,  as  they 
prostrated  themselves  on  his  approach  and  remained  in 
this  humble  position  until  he  and  his  escort  had  passed, 
a  courtesy  they  always  extended  to  their  chiefs.  He 
found  no  indications  of  cannibalism,  but  human  sacri- 
fices, as  in  all  the  South  Sea  islands,  were  frequently 
offered.  On  his  return  from  a  voyage  to  the  west  coast 
of  America  the  next  year  he  was  killed  by  the  natives 
soon  after  landing  at  the  island  of  Hawaii,  at  a  place 
now  indicated  by  a  monument  to  the  memory  of  the 
intrepid  explorer.  The  killing  of  Captain  Cook  was 
provoked  by  a  drunken  brawl  of  his  sailors,  which  in- 
censed the  natives,  and  their  wrath  centered  on  the 
leader  of  the  expedition.  His  body  was  interred,  and 
not,  eaten,  as  is  so  often  claimed.  The  political  con- 
dition of  the  islands  under  the  rule  of  different  chiefs, 
was  a  stormy  one,  wars  between  the  different  islands 
and  tribes  being  frequent,  until  the  Napoleon  of  the 
islands,  Kamehameha  I — ^born  1737,  died  on  the  island 
of  Hawaii,  1819 — after  many  bitter  wars  gained  su- 
premacy over  all  of  the  islands  and  ruled  them  in  the 
capacity  of  a  king.     His  reign  was  humane  and  wise. 


IIAWAIIAN    ISLANDS, 


47 


He  abolished  hunuin  sacrifice  and  introduced  many 
otlier  reforms  most  creditable  to  savage  rule.  With 
the  death  of  Kamehameha  V  the  reigning  family  be- 
came extinct,  and  Kalakana  was  elected  king.    He  died 


Fig.  9. — Natives  and  native  liouse. 

at  the  Palace  Hotel,  San  Francisco,  Jan.  20.  1891.  His 
sister,  Liliuokalani,  succeeded  to  the  throne.  By  a 
bloodless  revolution  she  was  deposed,  and  the  kingdom 
became  a  republic  Jan.  19,  1893.  After  a  number  of 
futile  previous  attempts  annexation  was  effected  by  an 


48  AROUND    THE    WORLD    VIA    INDIA. 

act  of  Congress,  July  14,  1900.  The  present  adminis- 
tration has  already  made  many  radical  changes  in  the 
government  of  the  islands  which  can  not  fail  in  bring- 
ing abont  a  more  prosperous  future. 

CLIMATE. 

The  Hawaiian  Islands  enjoy  an  equable  and  salu- 
brious climate.  It  is  the  land  of  sunshine  and  breezes. 
The  northeast  trade  winds  fan  the  islands  225  to  301 
days  out  of  the  year,  and  their  cooling  and  invigorating 
effects  are  enhanced  by  the  daily  land  breezes.  Anyone 
who  visits  Honolulu  for  the  first  time  and  walks  or 
rides  along  its  well-paved  and  clean  streets  any  time 
of  the  year  from  8  a.  m.  to  5  p.  m.  may  feel  the  effects 
of  heat  and  be  thrown  into  a  perspiration,  when  sud- 
denly a  land  breeze  descends  from  the  mountains,  cool 
and  refreshing,  making  the  visitor  forget  that  he  is  in 
a  subtropical  region.  It  is  only  when  the  atmosphere 
sleeps  during  midday  that  the  stranger  feels  at  all  un- 
comfortable and  seeks  relief  in  the  shade.  The  aver- 
age temperature  throughout  the  year  is  from  69  to  78 
F.,  extremes,  50  to  90  F. 

NATIVE  POPULATION. 

The  Hawaiians  are  Polynesians,  resembling  in  hab- 
its and  appearance  the  South  Sea  Islanders,  who  by 
migration  eastwar'd  f*rom  the  Malay  peninsula  pro- 
gressed from  island  to  island,  undergoing  certain 
changes  under  climatic  and  other  influences,  but  re- 
taining to  a  great  extent  their  originality.  In  intelli- 
gence they  are  far  superior  to  the  negro  race,  to  which 
they  have  absolutely  no  resemblance  (Fig.  9).  Theii; 
greatest  fault  is  inborn  indolence.  The  average  native 
makes  no  unnecessary  effort,  mental  or  physical.  They 
are  as  indifterent  as  children.  They  abhor  agricultural 
pursuits  and  prefer  to  live  on  waterfronts,  where  they 
can  secure  their  fish  supply  without  much  effort  and 
amuse  themselves  with  their  national  sports,  swimming 


HAWAIIAN    ISLANDS. 


49 


and  canoe  or  surf  riding.  They  do  not  take  kindly  to 
the  professions,  and  will  only  work  under  the  pressure 
of  necessity.  Civilization  has  rather  increased  than  di- 
minished their  repugnance  to  labor. 

The  natives  are  generous  to  a  fault,  honest,  easy  go- 
ing, with  a  happy  disposition,  but  have  an  inordinate 
fondness  for  flattery.  They  are  very  fond  of  flowers 
and  music,  but  have  little,  if  any,  sense  of  art.  The 
leis  (flower  wreath)  is  found  on  all  festival  occasions, 
and  is  especially  conspicuous  at  the  luau  feasts 
(Fig.  10). 


Fig.  10. — ^Luau,  National  Hawaiian  Feast. 

The  mortality  among  the  natives  since  the  whites 
came  to  the  islands  has  been  frightful.  When  Captain 
Cook  discovered  the  islands  all  of  them  were  densely 
populated,  not  less  than  200,000.  In  1836  their  num- 
ber was  reduced  to  108,579,  and  at  present  it  does  not 
exceed  39,000.  In  1848  one-fourth  of  the  population 
was  carried  off  by  an  epidemic  of  measles ;  shortly  after 
another  3,000  died  of  smallpox.  The  rapid  decrease 
in  the  native  population  and  their  unwillingness  to 
work  creates  a  field  for  foreign  laborers.    In  1898  there 


50  AROUXD    THE    WORLD    VIA    IXDIA. 

were  in  the  islands  30,000  Japanese,  24,000  Chinese  and 
16.000  Portuguese,  and  since  that  time  the  number  of 
foreign  laborers  must  have  certainly  rather  increased 
than  otherwise,  as  there  has  been  a  considerable  influx 
from  Porto  Eico  since  the  Spanish-American  war. 

The  effects  of  civilization  on  the  natives  has  been 
harmful  as  well  as  beneficial.  The  first  missionaries 
came  to  Honolulu  in  1820,  when  it  was  a  village  of  huts, 
with  3,000  inhabitants.  For  a  long  time  they  labored 
in  vain,  but  in  1837  a  strong  religious  movement  swept 
over  the  islands,  and  in  a  very  few  years  paganism  had 
entirely  disappeared,  at  least  on  the  surface.  Ee- 
ligion,  however,  did  not  change  the  habits  of  the  people 
to  any  extent,  for 

"Nothing  is  stronger  than  custom." — Ovid. 

The  missionaries  have  brought  these  people  the  in- 
estimable blessings  of  religion  and  education,  but 

"No  sooner  is  a  temple  built  to  God,  but  the 
Devil  builds  a  chapel  near  by." — Herbert. 

Education  in  Hawaii  is  now  compulsory,  and  within 
the  reach  of  every  child.  There  is  no  need  for  any 
young  man  or  woman  to  leave  the  islands  for  a  good 
general  education,  as  Honolulu  has  most  excellent 
schools,  including  a  college  and  high  school.  Churches 
are  numerous,  both  Catholic  and  Protestant.  The 
churches  are  better  attended  than  in  the  states,  and 
the  people  pay  closer  attention  to  the  worship  than  our 
own.  They  are  emotional  and  easily  influenced  for 
right  and  wrong.  On  the  whole,  the  moral  status  of  the 
Hawaiian  would  compare  well  with  that  of  any  of  our 
communities.  On  the  other  hand,  the  whites  brought 
to  the  islands  the  devastating  infectious  diseases  which 
have  already  destroyed  nine-tenths  of  the  population, 
and  which  threaten  complete  extinction.  The  rum  shops 
and  gambling  are  likewise  the  fruit  of  the  white  man's 
invasion.  Syphilis  was  imknown  until  the  sailor  and 
the  adventurer  disgraced  the  soil  of  Hawaii.     It  must 


HAWAIIAN    ISLANDS. 


51 


not  be  forgotten  that  the  mind  of  the  aborigines  is  more 
susceptible  to  the  reception  of  vice  than  virtue,  and  the 
Hawaiians  are  no  exception  to  this  rule,  so  that  many 
of  their  original  natural  virtues  are  on  the  wane.  On 
the  whole,  the  natives  have  paid  dearly  for  what  they  re- 
ceived from  the  white  man,  as  the  very  soil  which  be- 
longed to  them  has  largely  passed  out  of  their  hands, 
and  is  now  owned  bv  forei  owners. 


Fig.    11. — The  government  house,    Honolulu. 


PREVAILING   DISEASES. 

Since  the  government  of  the  islands  has  fallen  into 
the  hands  of  the  white  population  every  possible  effort 
has  been  made  to  protect  the  natives  against  the  spread 
of  infectious  diseases.  The  board  of  health  has  been 
watchful  and  active  in  its  efforts  to  improve  the  sani- 
tary condition  of  the  islands,  more  especially  that  of 
the  capital  city,  Honolulu.  Like  all  primitive  peoples, 
the  Hawaiians  have  absolutely  no  appreciation  of  the 
importance  of  hj^giene  and  sanitation,  and  consequently 
the  surveillance  of  sanitary  matters  requires  constant 
watchfulness  on  the  part  of  the  board  of  health. 


52  AKOUXD    THE    WOKLD    VIA    INDIA. 

The  efficiency  of  the  Hawaiian  Board  of  Health  will 
compare  well  with  any  of  our  state  boards.  It.  is  made 
up  of  energetic  men,  who  do  their  duty  fearlessly  and 
without  regard  to  consequences.  The  present  hoard, 
recently  appointed  and  organized,  is  made  up  of  Dr. 
C.  B.  Cooper,  president ;  Dr.  W.  H.  Mays,  S.  K.  Kane, 
Esq. ;  M.  P.  Kobinson,  Esq. ;  F.  C.  Smith,  Esq. ;  E.  C. 
Winston,  Esq.,  and  Lorrin  Andrews,  Esq. 

The  last  report,  for  the  six  months  ending  June  30. 
1903,  contains  much  valuable  material  concerning  the 
present  prevailing  diseases.  It  is  a  source  of  gratifi- 
cation to  know  from  this  publication  that  the  reports 
of  the  government  physicians  from  nearly  every  district 
are  unanimous  in  stating  that  pulmonary  tuberculosis, 
that  has  gained  such  a  firm  hold  on  the  natives,  is  not 
increasing.  The  report  shows  that  during  that  time 
occurred  13  deaths  from  bubonic  plague,  from  typhoid 
fever,  11;  diarrhea  and  dysentery,  32;  pulmonary  tu- 
berculosis, G4;  beri  beri,  6;  pneumonia,  39.  The  great 
mortality  from  tuberculosis  shows  to  what  extent  the 
disease  is  still  prevailing.  Honolulu,  being  one  of  the 
stations  on  the  ocean  highway  to  the  Orient,  is  con- 
stantly menaced  with  the  plague;  and,  notwithstanding 
the  great  vigilance  of  the  quarantine  physician,  isolated 
cases  will  occur  from  time  to  time.  The  stringent 
measures  resorted  to  by  the  board  of  health  the  mo- 
ment a  case  is  discovered  have  so  far  protected  the 
islands  against  an  epidemic  of  this  much-dreaded  dis- 
ease. The  most  severe  outbreak  of  the  plague  occurred 
in  1890.  The  disease  was  imported  from  Hongkong, 
and  broke  out  among  the  Chinese  and  Japanese  with 
great  virulence,  and  soon  attacked  80,  of  which  number 
only  14  recovered.  A  group  of  suspects  of  500  to  700 
was  quarantined,  and  in  this  way  the  further  spread 
of  the  disease  was  checked.  After  all  danger  from  in- 
fection had  been  passed  the  barracks  were  burned.  Dur- 
ing the  entire  epidemic  only  3  whites  were  attacked, 
and  one  of  them  died.    The  same  can  be  said  of  cholera. 


HAWAIIAN    ISLANDS. 


5a 


In  1895  cliolera.  also  imported  from  t.iic  Orient,  broke 
out,  but,  thanks  to  a  strin<;ent  ((uarantine  of  the  80  or 
90  cases,  70  per  cent.  l)ein<r  natives,  the  disease  was 
promptly    stamped    out,    never    extending    l)eyond    the 


Fig.  12. — Queen  Emma,  cunsoi-t  of  King  Kameliamelia  III. 

limits  of  Honolulu.  In  1880  a  severe  epidemic  of 
smallpox  broke  out  and  proved  very  virulent  in  the 
natives,  as  more  than  10  per  cent,  of  those  attacked 
died. 

Comnulsorv  vaccination,  as  now  enforced  by  the  board 


54  AKOUND    THE    "WORLD    VIA    INDIA. 

of  health,  will  prevent  all  possibility  of  a  similar  occur- 
rence in  the  future.  Scarlet  fever  has  never  been  epi- 
demic, and  diphtheria  has  alwaj^s  been  observed,  and  that 
very  seldom  in  isolated  cases.  Syphilis  is  not  so  com- 
mon as  formerly,  but  the  hereditary  effects  are  wide- 
spread and  severe,  and  present  and  future  generations 
will  be  made  painfully  aware  of  the  truth  of 

"Posterity  pays  for  the  sins  of  their  fathers." — 
Quintus  Curtius  Rufus. 

Measles  has  always  been  the  great  curse  of  the  primi- 
tive races,  and  it  has  claimed  thousands  of  the  Ha- 
waiian population.  The  fearful  mortality  attending 
this  disease  is  usually  attributed  to  the  recklessness  of 
the  patients,  as  they  will  not  keep  their  bed,  but  will 
persist  in  bathing  to  find  relief  from  the  fever  heat. 
I  believe,  however,  that  such  imprudence  on  the  part 
of  the  whites  would  not  result  so  disastrously  and  that 
the  frightful  death  rate  is  more  attributable  to  the 
slight  resistance  to  the  disease  on  the  part  of  the  na- 
tives. There  ought  to  be  very  little,  if  any,  typhoid 
fever  in  Honolulu  under  the  present  perfect  system 
of  water  supply  and  sewerage.  The  disease  occasionally 
affects  small  communities  where  the  sanitary  condi- 
tions are  not  so  completely  under  the  supervision  of 
the  government  physicians  stationed  in  the  23  different 
districts.  Maui  is  the  island  that  records  the  largest 
number  of  cases  of  malaria,  121  cases  of  dengue  and! 
malaria  in  six  months,  as  stated  in  the  last  health  re- 
port, while  Kauai  and  Molokai  report  none,  and  only 
3  cases  are  credited  to  Oahu  and  3  cases  of  typho-ma- 
laria  and  one  case  of  typhoid.  The  islands  continue 
to  supply  the  leper  settlement  with  new  inhabitants  to 
take  the  place  of  the  dead.  According  to  the  report  re- 
ferred to  above,  the  number  of  lepers  at  the  settlement 
at  present  is  888.  In  six  months  the  population  of 
lepers  was  increased  by  62 ;  at  this  rate  the  annual  ad- 
dition to  the  number  of  lepers  would  be  124.  The  re- 
port also  refers  to  a  large  number  of  suspects  that  re- 


HAWAIIAN    ISLANDS. 


55 


main  under  observation,  and  from  which  a  large  num- 
ber will  be  recruited  for  the  settlement  as  soon  as  an 
absolute  diagnosis  can  be  made. 

Dr.  W.  J.  Goodhue,  a  recent  graduate  of  Rush  ^Medi- 
cal  College,  has  taken  up  the  cause  of  the  Molokai 
lepers,  and  is  the  present  resident  medical  superin- 
tendent. He  has  already  introduced  many  reforms, 
and  is  earnestly  seeking  a  remedy  that  will  cure  his 
patients.  He  continues  the  Goto  treatment,  but  has 
no  faith  in  it.    At  the  suggestion  of  the  board  of  health 


Fig.  18. — Queen's  Hospital.  Honolulu,  establislied  by  King  Kame- 
hameha   III    and   Queen   Emma   in  1860. 

he  is  also  experimenting  with  the  '^'Violet  Eay."  At 
present  he  is  encouraged  by  the  results  of  sodium  caco- 
dylate.  In  his  report  he  says:  "In  sodium  cacodylate, 
an  arsenical  derivative  of  relatively  slight  toxicity  con- 
taining over  50  per  cent,  of  arsenic,  I  believe  I  have 
found  a  remedy  of  great  promise  in  the  treatment  of 
leprosy.  My  attention  was  first  attracted  to  the  remedy 
by  clinical  reports  of  the  success  attained  with  it  in  the 
treatment  of  psoriasis,  and  in  diseases  in  which  the 
wasting  and   disassimilation   are   marked   features,   al- 


56  AROUXD    THE    AVOKLD    VIA    IXDIA. 

though  I  can  not  find  any  account  of  its  ever  liaving 
been  employed  in  leprosy.  It  is  administered  hypoder-. 
mically,  per  os,  or  by  rectal  enema,  and  it  appears  to  be 
entirely  free  from  any  appreciable  irritative  effects  on 
the  intestinal  or  rectal  mucosa.  I  have  a  limited  num- 
ber of  patients  on  this  treatment  who,  so  far,  after  be- 
ing on  the  treatment  for  from  two  to  three  months, 
show  very  decided  improvement,  and  I  am  only  await- 
ing a  large  supply  of  the  drug  before  materially  in- 
creasing the  number  of  patients,  when  I  hope  to  submit 
a  detailed  and  favorable  account  to  the  board  of  health 
of  the  results  obtained.^' 

Before  disposing  of  the  subject  of  leprosy  and  in 
reference  to  a  former  communication  on  the  same,  I 
will  add  that  during  my  short  visit  at  Honolulu  en 
route  I  met  a  number  of  the  most  influential  ph3^sicians, 
and  they  were  all  unanimously  opposed  to  making  the 
whole  Molokai  Island  a  leper  home.  They  base  their  op- 
position on  business  principles.  They,  as  well  as  the 
business  men  of  the  islands,  fear  that  if  this  were  done 
the  outside  world  would  be  prejudiced  against  the 
islands,  and  in  consequence  the  value  of  property 
would  be  depreciated  and  business  injured.  There  is 
considerable  weight  to  this  argument  for  the  present, 
but  as  in  the  course  of  time,  when  it  becomes  gen- 
erally known  that  the  colonization  of  the  lepers  would 
be  limited  to  the  Molokai  Island,  such  objection  would 
no  longer  apply.  Still,  this  is  a  matter,  as  I  have  stated 
before,  for  the  territorial  and  general  government  to 
consider  and  decide. 

THE  MEDICAL  PROFESSION. 

The  medical  profession  of  the  island  territory  is  one 
of  the  most  desirable  things  that  we  have  inherited  by 
the  annexation,  a  worthy  addition  to  the  large  body  of 
practitioners  of  the  United  States.  It  is  made  up 
largely  of  young,  energetic  men  who  came  here  well 
prepared  for  their  lifework.     The  door  of  entrance  to 


HAWAIIAN    ISLANDS.  57 

the  practice  of  medicine  ir?  well  <,niiir(]('(l.  I<]verv  can- 
didate must  pass  a  satisfactory  examination  before  a 
l)()ai'd  of  examiners  appointed  by  the  <i:overnor.  "^Fhis 
board  consists  of  four  members,  who,  to  Judge  from  tlie 
character  of  the  men  who  have  been  licensed,  make  no 
farce  of  the  examination,  as  is  only  too  often  done  in 
the  states.  The  question  of  school  is  not  considered, 
all  must  pass  the  same  critical  test,  and  if  found  quali- 
fied they  can  practice  any  system  they  please.  There 
are  now  about  100  licensed  physicians  in  the  islands, 
about  60  in  Hololulu,  and  the  rest  scattered  in  the  23 
districts. 

Every  district  has  what  is  called  a  government  phy- 
sician, who  looks  after  the  poor  and  sanitary  matters, 
and  is  paid  on  an  average  of  $1,000  a  year  for  his  serv- 
ices. These  doctors  make  a  semi-annual  report  of  their 
work  to  the  board  of  health.  Through  these  channels 
the  board  of  health  reaches  the  most  distant  parts  of 
the  islands,  and  thus  insures  prompt  and  efficient  sani- 
tation. Among  the  older  practitioners  in  Honolulu  be- 
long Drs.  McGrew  and  McKibbin  and  Dr.  W.  E.  Tay- 
lor, a  retired  naval  surgeon.  Dr.  C.  B.  Cooper  is  presi- 
dent of  the  territorial  State  Board  of  Health.  Dr.  F. 
E.  Day,  a  graduate  ol  Eush  Medical  College,  Dr.  C.  B. 
Wood,  ex-interne  at  Cook  County  Hospital,  and  Dr. 
Walter  Hoffmann,  a  graduate  of  Germany,  are  the  lead- 
ing practitioners.  The  sick  of  the  yellow  races  are 
cared  for  by  13  Japanese  and  2  Chinese  physicians. 
For  the  benefit  of  recent  graduates  I  would  say  that 
Hawaii  has  all  the  physicians  it  can  well  support  at 
present;  it  is  no  Paradise  or  Eldorado  for  a  new  begin- 
ner. The  field  is  well  occupied,  as  most  of  the  men 
would  be  hard  to  discoimt,  and  the  present  depressed 
condition  of  the  sugar  interests  is  felt  throughout  the 
islands.  There  are  only  three  or  four  men  in  Honolulu 
who  have  been  there  for  years  and  who  are  very  popu- 
lar, that  can  put  down  their  annual  income  in  five 
figures.     Some  of  the  physicians  with  a  smaller  income 


58  AKOUXD    THE   WORLD    VIA    IXDIA. 

add  to  it  by  conducting  at  the  same  time  some  business 
enterprise. 

queen's  hospital. 

Queen's  Hospital  (Fig.  13)  is  the  onty  hospital  in 
Honolulu.  It  was  erected  and  endowed  by  the  late 
Queen  Emma  (Fig.  12),  who  took  a  deep  interest  in 
charity  work.  It  is  a  handsome  structure,  located  in 
the  center  of  a  park  ornamented  with  flowers  and  tropi- 
cal trees  and  shrubs.  The  palm  avenue  leading  from 
the  street  to  the  entrance  of  the  hospital  is  one  of  the 
finest  I  have  ever  seen.  The  hospital  is  managed  by  a 
board  of  trustees,  composed  of  40  members,  and  repre- 
sents the  most  influential  men  of  the  city.  The  hospi- 
tal has  a  capacity  for  90  patients,  and  the  new  wing, 
Avhich  is  nearing  completion,  will  accommodate  an  addi- 
tional 50.  Four  physicians,  appointed  by  the  board  of 
trustees,  constitute  the  staff.  Formerly  these  physicians 
were  salaried,  but,  I  presume  in  consequence  of  the  ad- 
ditional expenditure  incident  to  the  building  of  the  new 
wing,  and  the  depression  in  the  value  of  the  real  estate 
in  which  the  endowment  largely  consists,  the  salaries 
have  been  withdrawn.  The  equipments  of  the  hospital 
are  adequate,  and  the  new  operating  room  will  fill  a 
long-felt  want.  The  nursing  is  in  the  hands  of  8 
trained  nurses,  who  receive  a  monthly  salary  of  from 
$40  to  $50.  Experiments  have  been  made  to  train  na- 
tive young  women,  but  they  failed,  so  that  the  hospital 
is  put  to  the  large  expense  of  hiring  trained  nurses. 
The  indigent  native  sick  are  amply  provided  for,  and 
others  pay  according  to  their  means. 

MEDICAL   SOCIETY   OF   THE   HAWAIIAN  TERRITORY. 

The  first  attempt  to  organize  the  medical  •  profession 
Hawaii  was  made  through  the  instigation  of  Dr.  H.  W. 
Howard,  in  1893,  when  the  physicians  of  Honolulu 
met  from  time  to  tjme  in  each  other's  houses,  thus  com- 
bining social  with  professional  interests.  Under  the 
above  title  a  permanent  organization  has  been  effected^ 


HAWAIIAN    ISLANDS.  59 

with  monthly  meetings  at.  which  physicians  from  the 
different  islands  attend,  so  far  as  transportation  facili- 
ties will  permit.  It  is  a  source  of  regret  that  the  trans- 
actions so  far  have  not  been  published,  and,  in  view  of 
the  importance  of  the  subjects  that  are  discussed  from 
time  to  time,  more  particularly  everything  pertaining 
to  tropical  diseases  and  island  sanitation,  the  reports 
of  many  of  these  meetings  would  make  interesting  and 
profitable  reading  for  the  medical  world, 
Pago  Pago,  Samoa,  July  21. 


OUR  POSSESSION  IN  SAMOA  FROM  A  MEDI- 
CAL STANDPOINT. 


We  landed  at  Pago  Pago  on  Thursday,  July  21,  at 
6  :30  a.  m.  The  natives  were  on  hand  to  welcome  us, 
and  many  a  greeting  was  expressed  in  the  euphonious 
word  'Halofa"  (love  to  you).  The  moment  the  ship  was 
anchored  in  the  harbor  a  fleet  of  canoes  surrounded  it 
and  their  brown  inmates  in  native  attire — men  whose 
only  garment  was  a  breechcloth,  women  in  the  loose, 
comfortable  Mother  Hubbard  calico  dress,  children 
with  no  clothing  incumbrances  of  any  Kind,  all  of  them 
with  a  copious  growth  of  jet  black  long  curly  hair 
freely  exposed  to  sunlight  and  breeze,  with  upturned 
faces  and  large,  gentle,  imploring  coal  black  eyes — Avere 
soliciting  patronage  for  the  products  of  their  charming 
island.  Gaudily  painted  tapa  cloth  made  of  the  bark 
of  a  tree,  coral  beads,  baskets  of  various  designs  and 
sizes,  shells  and  tropical  fruits  were  the  principal  ar- 
ticles offered  for  sale.  The  competition  between  the 
dusky  vendors  was  not  a  spirited  one;  it  made  little 
difference  who  reaped  the  greatest  profits,  as  in  a  short 
time  the  gain  of  the  morning's  sales,  according  to  the 
customs  of  the  island,  would  soon  be  shared  equally 
by  all.  Our  time  in  the  harbor  being  limited  to 
a  few  hours,  I  Avas  very  anxious  to  improve  every 
minute  in  studying  the  resources  of  the  island,  its  peo- 
ple and  their  diseases.  By  previous  appointment  I  was 
met  on  board  by  Dr.  H.  E.  Odell,  P.  A.  Surgeon  U.  S. , 
Navy,  the  medical  officer  of  the  training  ship  Adams, 
now  in  the  harbor  (Fig.  14).  To  this  officer  I  am 
greatly  indebted  for  many  charming  courtesies  and  most 
valuable  information.  He  took  me  ashore  at  once  in 
the  government  launch  and  on  landing  introduced  me 
to  Chief  Pan  Pan  of  the  village  Aua,  Avho  happened  to 


62  AEOUXD    THE    WORLD   VIA    IXDIA. 

be  i)resent,  a  man  liighh^  esteemed  by  the  natives  and 
whites  for  his  excellent  character  and  good  judgment. 
His  distinctive  dress  consisted  of  a  long  white  coat, 
with  shoulder-straps  of  the  same  color  with  a  narrow 
border  of  blue.  His  whole  bearing  impressed  one  with 
the  dignity  of  his  office  and  firmness  of  his  character. 
From  the  time  we  entered  the  harbor  until  we  reached 
the  shore  I  had  looked  in  vain  for  the  American  flag. 
I  saw  the  bare,  tall  pole  in  front  of  the  custom-house 
and  was  wondering  what  had  happened  in  international 
politics  since  I  left  San  Francisco,  that  it  should  have 
been  stripped  of  our  colors.  The  information  came 
without  asking'  any  questions.  A  few  minutes  after 
landing  a  motley  crowd  gathered  around  that  pole, 
and  presently  I  had  the  pleasure  of  witnessing  the 
hoisting  of  the  American  flag  (Fig.  15).  This  is  a 
ceremony  that  takes  place  every  day  at  8  o'clock  in  the 
morning.  The  moment  the  Stars  and  Stripes  reached 
the  lofty  destination,  fluttering  in  the  fresh  morning 
breeze,  the  native  band  played  our  national  airs,  "My 
Country,  'Tis  of  Thee"  and  "Star  Spangled  Banner." 
and  the  mountains  re-echoed  the  strains  of  the  stir- 
ring music  so  dear  to  the  heart  of  every  American.  The 
ceremony  was  an  impressive  one.  The  native  guard, 
composed  of  72  picked  men,  magnificent  specimens  of 
physical  development,  wearing  a  red  turban,  white 
sweater  and  blue  trousers,  standing  at  attention  with 
arms  at  rest.  The  crowd  of  people,  including  many 
children,  stood  motionless,  not  a  word  being  spoken 
until  the  last  strains  of  the  music  had  died  away  in  the 
soft,  balmy  air  of  the  tropics,  when  the  guard  shoul- 
dered their  arms  and  marched  away  to  their  respective 
posts  of  duty  in  a  truly  soldierly  manner  and  the  crowd 
dispersed  as  quietly  and  silently  as  it  had  gathered. 
This  beautiful  ceremony  reminded  me  that  I  was  on 
American  soil  in  the  midst  of  the  vast  trackless  Pacific 
Ocean,  nearly  5,000  miles  away  from  the  western  lim- 
its of  the  United  States. 


OUI!    I'OSSESSroX    IX    SAMOA. 


63 


SKETCH   OF   THE  IlISTOlfY   OF  THE   ISLANDS   OF  SAMOA. 

Not  all  the  peoplo  of  the  United  States  are  aware  of 
the  fact  that  the  beautiful  island  of  Tiituila  of  the 
Samoan  archipelago  is  one  of  our  ocean  possessions,  and 
very  few  know  how  it  was  acquired.  In  making  in- 
quiries among  officers  and  passengers  of  the  Sierra  re- 
garding this  subject  I  became  satisfied  how  little  there 
is  known  about  it.     Tlic  history  of  Samoa,  especially 


Fig.    14. — Tutuila,    Samoa,    U.    S.    Naval    Station. 

the  recent  part  of  it,  leading  up  to  the  time  Tutuila 
was  ceded  to  the  United  States,  is  a  very  interesting 
one,  and  does  not  reflect  much  credit  on  some  of  the 
foreign  powers,  especially  Germany.  The  extent  to 
which  Germany  meddled  with  Samoan  affairs  and  the 
fact  that  she  now  owns  the  two  largest  islands,  Savaii 
and  Upolu,  are  matters  difficult  to  explain.  The  recent 
history  of  Samoa  is  a  tangle  difficult  to  unravel  without 
lo-^ing  the  thread,  owing  to  the  rapidity  of  succession  of 


G4  AIJOUXD    THE    WORLD    VIA    INDIA. 

events  caused  by  contending  internal  political  factions, 
complicated  by  outside  interference.  Space  will  permit 
me  only  to  give  a  few  outlines.  The  Samoan  arch- 
ipelago, composed  of  not  less  than  fourteen  volcanic 
islands  with  numerous  adjacent  islets,  lies  nearly  east 
and  west  between  the  parallels  13°  31'  S.  and  14°  31' 
S.,  and  longitude  172°  45'  W.  and  168°  9'  W.  The 
last  volcanic  eruption  occurred  in  Savaii  in  1866.  The 
islands  were  first  seen  by  Eoggeveen,  but  their  discov- 
ery is  generally  accredited  to  Bougainville,  who  came 
there  in  1768  and  stocked  them  with  domestic  animals. 
He  called  them  Navigator  Islands.  It  is  supposed  that 
the  islands  became  populated  by  Polynesians  migrating 
eastward  from  Sumatra,  via  the  Philippines  and  Ha- 
waii, by  a  party  of  less  than  fifty,  in  seven  canoes.  Two 
hundred  years  later  the  Tongans  invaded  the  islands 
and,  with  the  aid  of  Fijians,  drove  the  Samoans  into 
the  mountain  retreats.  The  hardships  endured  by  con- 
stant persecution  served  to  strengthen  the  Samoan 
forces,  who  finally  gained  the  upper  hand  and  cleared 
the  two  largest  islands,  and  later  all  of  them,  of  the  in- 
vaders. Cannibalism  was  introduced  by  the  Tongans. 
but  was  abandoned  before  the  arrival  of  the  explorers. 
The  missionaries  came  in  1833.  and  one  of  the  first 
fruits  of  their  indefatigable  labor  was  the  conversion 
of  Malietoa.  one  of  the  most  powerful  chiefs,  who  was 
christened  Davita.  This  event  gave  rise  to  a  religious 
wave  which  soon  reached  the  different  islands. 

Frequent  strifes  between  the  different  islands  and 
tribes  induced  the  natives  to  look  to  the  United  States 
as  early  as  1872  to  establish  order  out  of  chaos  by  re- 
questing our  government  to  send  Colonel  Steinberger 
of  Xew  York  as  adviser.  Two  years  later  President 
Grant  granted  the  request.  The  colonel  soon  improved 
the  administrative  affairs  of  the  islands  and  had  the 
full  confidence  of  the  natives.  His  influence  excited 
the  envy  of  the  British  and  in  less  than  a  year  he  was 
deported  by  a  Britsh  warship,  no  protest  being  made 


OUl 


l'()SSi:ssi()N    IX    SAMOA. 


65 


\)\  our  consul,  aiul  the  unwarranted  action  liad  the  full 
sanction  of  Kin<f  Malietoa  Lanpepa.  Insurrection  fol- 
lowed and  the  king  was  deposed.  From  now  on  th(.' 
political  events  followed  in  rapid  succession  by  the  ag- 
gressive interference  on  the  part  of  Germany.  Talavoa 
was  elected  king,  but  died  after  a  short  tumultuous 
reign,  and  Laupepa  again  succeeded  to  the  throne  only 
to  be  again  deposed  in  1S8S,  when  he  was  exiled  by  the 
(ierman  fleet.  Insurrection  under  the  leadership  of 
Malietoa  Mataafa  again  unsettled  political  affairs.  At 
one  time  the  German,  English  and  American  warships 


Fig\    lo. — Flag-raising    ceremonies. 


in  the  harbor  of  Apia  were  ready  to  clear  the  decks  and 
begin  w'ar  bet^veen  Germany  on  one  side  against  the 
other  two  powers,  when  the  great  storm  swept  them 
out  of  existence  with  the  exception  of  the  English  gun- 
boat Calliope.  Active  interference  on  the  part  of  the 
United  States  resulted  in  the  Berlin  conference,  which 
declared  in  favor  of  Laupepa  against  the  protest  of  the 
natives.  With  the  assistance  of  a  German  and  British 
warship  Laupepa  defeated  the  forces  of  Mataafa  near 
Apia  in  1893,  who  shortly  afterward  surrendered  to  the 
British   and   was   exiled   to   the   island   of   Jaluit   with 


66  AROUND    THE    WORLD    VIA    INDIA. 

twenty  of  his  chiefs,  where  he  remains  at  the  present 
time.  On  the  return  to  power  Laupepa  abdicated  in 
favor  of  Mataafa,  but  European  diplomacy  again  in- 
terfered and  he  remained  on  the  throne.  After  Lau- 
pepa's  death  in  1888  came  the  contest  between  the  ex- 
iled Mataafa,  who  had  the  German  influence,  and  Tana, 
the  son  of  the  dead  king.  After  a  number  of  fierce  con- 
tests the  matter  was  referred  to  Chief  Justice  Chambers, 
who  decided  in  favor  of  the  heir  to  the  throne.  Finally 
Admiral  Kautz  of  the  battleship  Philadelphia  interfered 
and  insisted  that  both  contesting  parties  should  lay 
their  claims  aside.  England  now  withdrew  from  the 
contest,  leaving  the  Germans  and  /Americans  in  the 
field  to  dispose  of  the  islands.  A  satisfactory  agree- 
ment was  reached  by  which,  on  jSTov.  8,  1899.  the  two 
largest  islands,  Savaii  and  Upolu,  were  ceded  to  Ger- 
many, and  Tutuila,  with  its  magnificent  harbor,  be- 
came the  property  of  the  United  States. 

OUR   SAMOAX   ISLAND. 

Out  of  the  internal  dissensions  and  whirlpool  of 
foreign  intervention  arose  for  us,  phoenix-like,  Tutuila, 
the  most  beautiful,  and.  from  a  strategic  standpoint,  the 
most  important  of  the  Samoan  Islands.  Pago  Pago 
liarbnr  is  land-locked,  with  an  average  of  thirty  fathoms 
in  deptl)  and  sufficiently  large  to  give  protection  to  a 
fleet  of  from  six  to  eight  of  the  largest  men-of-war. 
with  a  strip  of  land  belonging  to  it  amply  large  for  gov- 
ernment buildings,  barracks  and  coal  sheds.  The  har- 
bor is  hemmed  in  by  mountains  on  all  sides,  from  1.500 
to  2,500  feet  high,  except  the  narrow  gateway  commun- 
icating with  the  ocean.  These  momitains  form  a  safe- 
guard against  any  hurricane,  no  matter  how  severe  it 
might  be.  The  entrance  is  so  narrow  that  a  few  mines 
and  a  battery  on  the  high  hills  on  each  side  could  keep 
the  largest  naval  force  at  bay.  The  island  is  19  miles 
long  and  330  in  circumference.  A  num])er  of  islets 
belonffin<r  to  it  and  included  in  the  treaty  stretch  along 


OL'U    POSSESSIUX    iX    .SA.\[()A. 


0? 


tho  same  cast  and  west  line,  the  farthest  ahout  sixty 
miles  away.  The  main  an^  adjacent  islands  are  forest- 
clad,  without  a  bare  spot  in  the  dark  green  carpet,  ex- 
tending from  the  shores  to  the  highest  mountain  peaks. 
Tho  primitive  forests  have  never  been  disturbed,  as  the 
natives  have  had  no  use  for  timber  eit?ter  for  themselves 
or  barter.  The  forests  are  dense,  almost  impenetrable, 
and  some  of  the  trees,  especially  at  the  very  summit  of 
the  mountains,  are  of  prodigious  size  and  would  yield 
hardwood  timber  of  great  commercial  value.  The  rim 
of  lowland  at  the  base  of  the  mountains,  when  it  exists, 


Fig.  16. — Samoa  women  and  child. 

and  the  valleys  near  the  shore  line,  ara  covered  with 
groves  of  cocoa  palms,  and  wherever  a  sufficient  number 
of  these  trees  are  found  a  hut  or  small  hamlet  of  huts 
may  confidently  be  looked  for.  The  volcanic  formation 
of  the  entire  island  is  covered  with  a  thick  layer  of  the 
most  fertile  black  soil,  as  shown  by  the  size  of  the  trees, 
the  luxuriance  of  the  shrubs  and  plants  and  the  abun- 
dance of  nutritious  grass.  The  soil  and  climate  are 
admirably  adapted  for  the  growing  of  coffee,  cacao,  taro 
and  all  kinds  of  tropical  fruits. 

CLIMATE. 

The  climate  of  Tutuila  is  influenced  by  the  unbroken, 
dense,  virgin  forest.     We  see  here  a  very  instructive  ex- 


68  AKOUND    THE    WORLD    VIA    IXDIA. 

ample  of  what  such  forests  are  capable  of  accomplishing 
in  the  Avay  of  securing  an  adequate  rainfall.  Drought 
is  unknown.  The  rainy  season  in  the  Samoan  Islands 
is  supposed  to  be  during  the  first  three  months  of  the 
year,  but  in  Tutuila  it  rains  more  or  less  throughout 
the  year,  rendering  the  atmosphere  damp.  The  rain- 
fall last  year,  according  to  Dr.  Odell.  reached  nearly 
200  inches.  Every  ravine  leading  from  the  mountain 
heights  to  the  sea  has  its  rivulets  or  small  rivers,  which 
drain  off  the  excessive  moisture  of  the  saturated  soil, 
furnishing  the  inhabitants  all  over  the  island  with  a 
faultless  Avater  supply.  The  climate  is  uniform,  the 
tropical  heat  modified  by  sea  and  land  breezes.  The 
temperature  seldom  rises  above  85  degrees  F.  and  is 
rarely  less  than  72  degrees  F.,  although  on  rare  occa- 
sions the  thermometer  has  registered  as  low  as  60  de- 
grees F.  (Odell).  The  nights  are  generally  delightfully 
cool.  The  climate  is,  on  the  whole,  very  similar  to  that 
of  Hawaii. 

THE  PEOPLE. 

"They  eat,  they  drink,  and  in  communion  sweet 
quaff  immortality  and  joy." — Milton. 

The  Samoans  are  a  noble  race,  simple,  honest,  affec- 
tionate, peaceable  and  hospitable.  The  men  are  splen- 
did specimens  of  physical  development.  al)ove  average 
size,  and  with  a  courteous  and  noble  bearing.  I  ob- 
served several  women  who  were  close  to  the  six-foot 
mark  and  as  erect  as  the  poles  of  a  bamboo  thicket.  I 
noticed  that  many  of  the  women  and  some  of  the  men 
had  dark  brown  hair,  which,  I  was  informed,  was  the 
result  of  a  process  of  bleaching  with  lime,  done  either 
with  the  intention  of  ridding  it  of  its  live  inhabitants 
or  for  cosmetic  reasons.  The  Avomen  are  rather  fair- 
looking  when  young,  but  lose  their  attraction  before 
they  reach  the  age  of  30  by  premature  old  age  and 
obesity.  Tattooing  among  men  remains  as  a  national 
custom.     It  is  done  as  a  ceremony  as  soon  as  the  boys 


Ol'l;     I'OSSKSSIOX     IN     SA.MOA.  60 

attain  virility,  and  ilic  field  ol'  operation  corresponds 
with  that  part  of  the  body  covered  l)y  their  only  gar- 
ment— the  breechcloth — so  tliat  in  the  event  anything 
goes  wrong  with  this,  the  simplest  and  oldest  dress, 
they  should  not  appear  entirely  naked.  The  operation 
is  performed  hy  experts,  whose  implements  consist  of  a 
little  fine-toothed  comb  made  of  the  tusk  of  a  wild  boar, 
which  is  fastened  to  a  small  stick  in  the  form  of  a 
minnte  rake.  The  teeth  are  dipped  into  the  staining 
material,  and  with  blows  of  a  little  stick  on  the  bhmt 
end  of  the  comb  they  are  made  to  penetrate  deep  enough 
to  drive  the  stain  into  the  deeper  layers  of  the  skin. 
T]ie  operation  is  attended  by  great  pain,  and  lasts,  ac- 
cording to  the  artistic  designs  employed,  from  five  hours 
upward.  The  lines  of  tattooing  are  exceedingly  fine  and 
the  patterns  are  often  quite  artistic,  as  I  had  an  abun- 
dance of  opportunity  to  observe.  There  is  very  little 
crime  among  the  Samoans.  For  four  years  there  has 
been  only  one  murder  in  Tutiiila  with  its  G,000  inhab- 
itants. The  whites  never  lock  their  doors.  What  we 
look  on  as  petty  thefts,  such  as  taking  away  without  per- 
mission a  loaf  of  bread,  a  fish  or  any  kind  of  fruit,  is 
not  regarded  in  the  light  of  crime  by  the  childlike  Sa- 
moan.  The  next  day  the  neighbor  so  treated  will  even 
up  the  account  in  a  similar  manner.  So  far  as  the  food 
supply  is  concerned,  the  Samoans  constitute  one  great 
family,  giving  and  taking  as  occasion  may  demand,  and 
the  stranger  is  always  w^elcome  to  more  than  his  share. 
Family  life  is  ideal.  The  father  rules  supreme;  old 
age  is  respected;  the  ties  of  relationship  and  friendship 
are  strong.  No  operation  can  be  performed  on  a  Sa- 
moan  without  a  previous  family  council.  If  the  father 
is  the  patient  the  sons  decide  the  matter,  if  any  other 
member  of  the  family  is  concerned  the  father  alone 
has  the  power  to  object  to  or  sanction  the  operation. 
The  bedside  of  the  sick  is  never  deserted  by  the  immedi- 
ate members  of  the  family,  and  anxious  relatives  and 
friends  are  never  far  away. 


70  AROUND   TELE   AVORLD    VIA    INDIA. 

The  educational  advantages  of  Tutuila  are  as  yet 
in  their  infancy,  a  defect  which  should  soon  be  reme- 
died, as  the  children  are  very  fond  of  school  work.  The 
Catholic  Sisters  are  here,  and,  as  on  so  many  other 
frontier  lines,  they  are  the  pioneers  in  placing  within 
reach  of  the  ignorant  children  the  means  of  obtaining 
an  education.  They  have  opened  a  school  in  a  village 
near  Pago  Pago,  which  is  already  filled  to  overflowing 
with  the  little  dusky  scholars.  All  of  the  inhabitants 
are  nominally  Christians,  but  religion  has  failed  to 
wipe  out  many  traces  of  paganism.  There  are  very  few 
legal  marriages  consummated.  The  native  custom  still 
prevails.  Man  and  wife  consent  to  live  together,  and 
continue  to  do  so  as  long  as  the  matrimonial  sky  is 
clear,  but  should  anything  occur  contrary  to  the  expec- 
tations of  the  husband  the  tie  is  severed  by  returning 
the  wife  to  her  parents  or  relatives.  The  children  are 
always  provided  for.  Unless  other  arrangements  are 
made  which  are  satisfactory  to  both  parties,  the  sons 
remain  with  their  father  and  the  daughters  accompany 
their  mother  (Fig.  16). 

The  kahuna,  or  native  medicine  man,  remains,  and 
has  not  lost  his  influence  among  his  people.  They  con- 
tinue their  mysterious  ceremonies  and  the  use  of  herbs 
and  roots  in  battling  with  the  diseases  they  are  called 
on  to  treat.  The  remarks  of  Father  Damien  concerning 
the  native  doctors  of  Hawaii  apply  to  the  kahunas  of 
Samoa :  "We  have  to  fight  their  doctors,  who  are  gen- 
erally nothing  but  sorcerers.  In  cases  of  sickness  idola- 
trous sacrifices  are  still  in  use.  All  diseases  are  at- 
tributed to  mysterious  causes.  It  is  very  hard  to  dis- 
abuse these  poor  people  of  such  superstitious  notions." 
Superstition  remains  unshaken  by  the  teachings  of  the 
gospel,  a  strong  proof  of  the  truth  that 

"Nothing  has  more  power  over  the  multitude 
than  superstition;  in  other  respects  powerless, 
ferocious,  fickle,  when  it  is  once,  captivated 
by  superstitious  notions,  it  obeys  its  priests  better 
than  its  leaders." — Quintus  Curtius  Rufus. 


OUR  POSSESSION   IN   SAMOA.  71 

PRESENT  FORM  OF  GOVERNMENT. 

Our  government  has  very  wisely  interfered  as  little 
as  possible  with  native  rule.  The  harbor,  with  a 
strip  of  land  belonging  to  it,  is  exclusively  under  the 
control   of  the  officer  in  command  of  the  naval  force 


Fig.     17.— Tamasese.       Fiue    specimen    of    Samoan. 

stationed  there.  He  is  at  the  same  time  the  comman- 
dant of  the  island,  to  whom  the  chiefs  can  appeal  in  all 
matters  in  which  they  find  it  necessary  to  obtain  ad- 
vice, or  when  they  fail  to  adjust  local  difficulties  in 
their  respective  communities.  The  naval  surgeons  sta- 
tioned at  Pago  Pago  have  in  charge  the  sanitation  of 


72  AKOUXD    THE    WORLD    VIA    INDIA. 

the  island  and  the  care  of  the  sick  poor  natives.  They 
have  alread}'  succeeded  in  securing  for  Pago  Pago,  a 
village  of  1,500  inhabitants,  a  pure  water  supply  and 
many  other  sanitary  improvements.  The  greatest  fault 
with  the  Sanioans  is  their  inborn  laziness.  They  will 
not  work.  The  government  has  now  under  way  many 
improvements,  and,  although  the  wages  for  this  part 
of  the  world  are  large,  $1  a  day,  it  had  to  import  labor- 
ers from  other  islands  to  do  the  work.  Civilization  has 
rather  increased  than  diminished  this  inherent  repug- 
nance to  labor. 

KAVA  DRINKING. 

Kava  is  the  national  drink  of  the  Samoans.  They 
have  not,  like  our  Indians,  an  ungovernable  desire  for 
alcoholic  stimulants.  Kava  is  the  fleshy  root  of  Piper 
methysticiim,  a  succulent  plant  about  four  feet  in 
height,  with  large,  long  petioled  leaves.  In  propagat- 
ing the  plant  all  that  is  necessary  is  to  break  off  one 
of  the  leaves  at  its  point  of  insertion,  including  the 
bulbous  base  of  the  petiole,  and  stick  it  into  the  moist, 
rich,  black  soil.  Kava  drinking  is  a  ceremony.  Dr. 
Odell  was  kind  enough  to  give  me  an  opportunity  to  ob- 
serve this  ceremony  in  all  its  details  and  to  sample  the 
product.  Whenever  possible  the  drink  is  prepared  by 
a  young  woman,  who  always  regards  the  task  as  oblig- 
atory, as  well  as  a  privilege,  if  not  of  distinction.  The 
first  young  lady  that  passed  Dr.  Odell's  bachelor  quar- 
ters was  called  in.  and  she  went  through  the  entire  per- 
formance with  a  grace  and  elegance  that  showed  she 
was  no  novice  in  that  part  of  her  domestic  functions. 
Formerly  the  root,  fresh  or  dried,  was  chewed  by  yoimg 
women.  Xow  the  dried  root  is  crushed  on  a  stone,  and 
the  coarse  powder  is  placed  into  a  shallow  bowl  of  hard 
wood,  supported  on  very  short  legs,  the  pride  of  every 
Samoan  family;  it  is  to  them  what  the  samovar  is  to 
the  Russians.  After  pouring  cold  water  on  the  pulver- 
ized  root  it  is  stirred   vifforouslv  with  l)oth   hands  for 


OLK    roSSKSSION     IN     SAMOA.  7'i 

about  (ive  mimites.  wlien  the  ^trainiii<^-  is  coiiiiucnccd 
with  a  swab  of  bark  fibers,  which  is  continued  until  all 
coarse  particles  are  removed  from  the  soapy-looking 
liquid;  the  entire  time  required  being  about  fifteen 
minutes.  The  liquid  has  a  peppery,  rather  pleasant 
taste.  It  is  served  in  cups  of  carved  cocoaniit  shell.  Thi:: 
drink  suits  the  place  and  climate  better  than  any  other 
beverage.  In  larger  quantities  it  produces  a  form  of 
slight  intoxication,  in  moderate  quantities  it  is  a  di- 
uretic and  slight  soporific. 

NATIVE    HOUSES. 

The  natives  remain  true  to  their  original  architecture 
in  the  construction  of  their  houses.  The  houses  are 
circular,  open,  the  round  dome-like  thatched  roof  rest- 
ing on  poles.  The  rafters  are  made  of  the  bread-fruit 
tree,  held  together  and  fastened  to  the  upright  poles 
with  an  intricate  lacework  of  bark  and  twigs.  The 
ground  is  covered  with  gravel.  The  bed  consists  of  tapa 
mats,  and  the  pillows  are  bamboo  sticks,  as  large  as  the 
arm  of  an  adult,  supported  by  props  at  each  end.  about 
four  inches  in  height.  The  cooking  is  done  outside.  As 
there  is  no  furniture  in  the  house  the  domestic  duties 
of  the  female  part  of  the  family  are  certainly  of  the 
simplest  kind.  The  tapa  cloth  is  made  of  the  thick, 
soft  bark  of  a  tree ;  it  is  pounded  into  thin  sheets,  dried 
and  painted  in  figures  most  pleasing  to  its  future  owner. 
It  is  the  principal  article  of  barter,  and  its  abundance 
or  scarcity  constitutes  the  wealth  or  poverty  of  the 
family.  These  open  houses  and  the  frugal  diet  are  most 
conducive  to  the  preservation  of  the  native's  health. 
Indoor  air,  combined  wfth  the  inherent  inactivity  of 
the  natives,  could  not  fail  in  multiplying  disease  and 
increasing  the  death  rate. 

DISEASES. 

Samoa,  like  all  islands  of  the  South  Pacific,  has  lost 
its  full  share  of  population  from  the  effects  of  the  in- 


7-1  AROUND    THE    WORLD    VIA    INDIA. 

fections  diseases  introduced  by  the  Avhites,  notably 
measles,  smallpox  and  tubercnlosis.  Vaccination  is  now 
generally  practiced  by  the  naval  surgeons,  and  the  na- 
tives subject  themselves  willingly  to  this  prophylactic 
measure.  The  spread  of  infectious  diseases  among  the 
natives  is  favored  by  their  habits.  Their  affectionate 
nature  and  the  strong  ties  of  friendship  bring  relatives, 
friends,  communities  and  different  villages  in  continu- 
ous and  frequent  contact  with  the  afflicted,  and  in  this 
manner  infection  is  carried  in  all  directions,  and  in  a 
remarkably  short  time  by  progression  from  place  to 
place  will  reach  the  most  remote  parts  of  the  island.  T 
imagine  that  any  efforts  to  cut  off  free  communication 
between  the  sick  and  well  would  appear  as  an  infliction 
of  cruelty  to  the  natives,  and  would  meet  with  their 
displeasure,  if  not  persistent  opposition.  It  is  this  free 
intercourse  among  the  people  that  accounts  for  the 
rapid  spread  of  measles  and  other  acute  infectious  dis- 
ease? over  the  entire  island.  The  natives  have  abso- 
lutely no  comprehension  of  the  importance,  much  less 
of  the  necessity,  of  enforcing  sanitary  precautions. 

Tuberculosis  affects  most  frequently  the  lungs,  as 
this  organ  becomes  most  frequently  predisposed  by  ca- 
tarrhal affections,  which  are  very  common;  next  in  fre- 
quency are  the  bones  and  joints,  and  lastly,  the  lymph- 
atic glands  and  intestinal  canal.  Leprosy  is  unknown 
in  Tutuila.  On  the  other  hand,  elephantiasis  is  very 
common.  It  is  estimated  that  of  the  male  population 
over  40  years  of  age.  50  per  cent,  are  suffering  from  this 
disease.  It  attacks  in  preference  the  lower  extremities, 
but  not  infrequently  the  upper  become  involved,  and 
scrotal  elephantiasis  is  by  no  means  rare  (Fig.  17). 
Dr.  Odell  has  operated  on  a  number  of  cases  of  scrotal 
elephantiasis  successfully,  in  which  the  mass  removed 
weighed  twenty  and  more  pounds.  The  disease  is  much 
more  common  in  men  than  women,  undoubtedly  be- 
cause they  are  more  frequently  the  subject  of  lesions, 
which  determine  infection.     The  disease  is  occasionally 


Fig.    IS. — A    native    of    Tutuila    affected    witli    elephantiasis    af- 
fecting  all    extremities. 


OUK    POSSESSION    IN    SAMOA.  77 

met  witli  in  children  less  than  10  years  of  age,  and  not 
infrequently  in  young  men  at  the  age  of  20.  There  are 
only  about  fifty  whites  in  the  island,  and  one  of  them,  a 
German,  has  been  a  resident  for  thirty-two  years.  He 
married  a  native  woman  and  raised  a  large  family  of 
children.  He  is  now  57  years  old,  and  contracted  the 
disease  twelve  years  ago.  It  affected  the  right  leg,  pur- 
sued a  somewhat  acute  course,  and  recently  a  compli- 
cating affection  of  the  knee  joint  made  an  amputation 
of  the  thigh  necessary.  He  made  a  good  recovery,  and 
will  leave  the  hospital  in  a  short  time  for  his  island 
home.  This  case^  like  so  many  others,  proves  that  a 
prolonged  residence  in  a  tropical  climate  renders  the 
whites  susceptible  to  infection.  Skin  affections  are  very 
prevalent  in  the  island,  more  especially  ulcers  of  the 
leg.  The  lack  of  clothing  and  footwear  is  undoubtedly 
largely  responsible  for  this,  exposing  the  parts  to  all 
sorts  of  mechanical  irritation  in  walking  through  the 
dense  bush  and  along  the  stony,  pebbly  shore.  These 
ulcers  yield  promptly  to  treatment  by  rest  and  the  local 
use  of  antiseptics.  Another  common  affection  is  the  so- 
called  tropical  abscess,  a  deep-seated,  somewhat  pub- 
acute  phlegmonous  inflammation,  attended  by  only 
slight  constitutional  disturbances.  It  is  undoubtedly 
the  result  of  infection  through  surface  lesions  which 
are  so  common,  that  is,  the  entrance  into  the  tissues 
of  some  nlild  form  of  pus  microbe  through  a  surface  in- 
fection— atrium.  These  abscesses  heal  very  promptly 
after  incision  and  drainage.  The  frequency  wnth  which 
hydrocele  is  met  with  is  attributed  by  Dr.  Odell  to 
Filaria  sanguinis  infection,  but  he  has  encountered  no 
difficulty  in  effecting  a  radical  cure  by  the  usual  opera- 
tive treatment.  Among  the  skin  affections  yaw  figures 
very  largely.  Dr.  Odell  showed  me  a  little  girl  suffer- 
ing from  this  disease.  The  lips  and  lower  segment  of 
the  face  were  covered  with  very  superficial  weeping  ul- 
cers. He  relies  on  mercury  and  chalk  incorporated  in 
a  salve  in  its  treatment,  and  has  never  seen  it  fail  in 


78  AltOUND    THE    WOULD    \IA    INDIA. 

effecting  a  speedy  healing  of  tlie  ulcerated  surfaces. 
Venereal  diseases  are  not  nearly  as  common  in  Samoa 
as  in  Hawaii  or  Tahiti,  as  the  women  are  more  virtu- 
ous, especially  in  their  relations  with  white  men.  The 
humidity  of  the  climate,  the  cool  nights,  absence  of 
clothing,  inadequate  cover  during  sleep,  are  respon- 
sible for  the  frequency  with  which  diseases  of  the  respir- 
atory organs  prevail.  Pneumonia  occurs  in  a  somewhat 
mild  form,  as  the  mortality  is  not  great.  Epidemics 
of  influenza  sweep  over  tlie  island  almost  every  year, 
and  affect  young  and  old,  but  the  disease  is  mild.  Ty- 
phoid fever  is  unknown.  Malaria  in  certain  localities 
is  quite  common,  but  always  of  the  mildest  type,  yield- 
ing readily  to  the  internal  administration  of  quinin. 
Diarrhea  among  infants  and  children,  caused  by  im- 
proper diet  and  exposure,  is  a  very  common  affection 
throughout  the  entire  year.  The  question  has  often 
occurred  to  me  whether  or  not  appendicitis  is  as  fre- 
quent among  the  people  who  live  largely  on  bread- 
fruit, bananas,  and  cocoanut,  that  is  a  laxative  vegetable 
diet,  as  it  is  with  us,  who  are  more  imprudent  in  the 
matter  of  diet.  That  the  disease  is  rare  in  the  islands 
of  the  South  Pacific  I  am  sure,  that  it  does  occur  is 
shown  by  a  case  recently  operated  on  at  Pago  Pago 
by  the  predecessor  of  Dr.  Odell.  The  patient  made  an 
excellent  recovery.  Dr.  Odell  has  been  at  his  present 
post  since  December,  but  so  far  has  not  seen  a  single 
case,  although  his  clientele  is  very  large.  Dysentery  as 
observed  here  is  not  a  common  disease,  and  yields  read- 
ily to  treatment.  The  island  has  so  far  escaped  the  rav- 
ages of  scarlatina  and  diphtheria,  the  scourges  of  ch.ild- 
hood  in  most  of  the  civilized  countries.  The  sanitary 
condition  of  the  island  appears  to  have  been  improved 
during  the  last  few  years,  in  consequence  of  which  the 
population   is  now   increasing. 


OUlt    POSSESSION    IN    SAiMOA.  81 

HOSPITALS. 

The  plural  number  of  this  subheading  will  undoubt- 
edly astonish  the  readers.  Pago  Pago  is  the  only  place 
in  the  island  that  affords  hospital  facilities,  and  this 
is  a  village  of  not  more  than  1,500  inhabitants,  and  our 
naval  force  does  not  exceed  120  men.  JSTeverthelcss,  it 
has  two  distinct  hospitals  adjoining.  One  is  a  small, 
one-story  cottage,  with  four  small  rooms,  in  which  all 
the  operating  is  done  and  in  which  the  more  serious 
cases  and  the  soldiers  are  cared  for.  It  would  be  diffi- 
cult to  crowd  into  this  hospital  more  than  twelve  or 
sixteen  cases,  and  yet  it  has  met,  so  far,  the  urgent 
needs  (Fig.  19).  The  second  hospital  is  a  unique  one. 
It  is  nothing  more  nor  less  than  a  large  native  house, 
built  by  the  natives,  for  which  the  government  paid  them 
$100.  The  cots  furnished  by  the  government  are  the 
only  articles  of  furniture.  The  natives  can  come  and 
go  as  they  please,  as  they  take  care  of  themselves.  Men 
and  women  live  under  the  same  roof.  In  case  of  an 
emergency  about  twelve  patients  could  find  shelter  here. 
Its  greatest  merit  is  the  perfect  ventilation.  At  the 
time  of  my  visit  I  found  here  three  patients,  one 
woman  recently  operated  on  for  extrauterine  pregnancy, 
a  man  affected  with  elephantiasis,  and  another  one  the 
subject  of  extensive  ulcers  of  the  leg.  These  patients 
have  no  lack  of  nurses,  as  a*  crowd  of  relatives  and 
friends  is  always  in  attendance.  Dr.  Odell  attends  to 
their  medical  and  surgical  needs. 

The  obstetrical  work  in  the  island  is  attended  to  by 
neighboring  women.  The  patient,  as  well  as  the  im- 
provised midwife,  have  only  one  thing  in  view  when  a 
new  Samoan  is  on  his  way  into  the  world,  and  that  is 
to  shorten  the  ordeal  as  much  as  possible  by  a  combina- 
tion of  muscular  force  on  the  part  of  the  patient  and 
her  attendant.  It,  speaks  well  for  the  climate  that, 
notwithstanding  even  ordinary  cleanliness  on  such  oc- 
casions is   ignored,  to  say  nothing   of  modern   aseptic 


82  AlIOUXD    THE    AVOKLD    VIA    IXDIA. 

precautions,  and  a  maximum  of  force  is  brought  into 
play,  sepsis  ver}-  seldom  follows,  and  the  mother  re- 
sumes her  customary,  routine  household  duties  the  next 
day.  These  strenuous  deliveries,  as  a  matter  of  course, 
result  in  extensive  lacerations  of  uterus  and  perineum. 
One  death  from  puerperal  sepsis  came  recently  under 
the  care  of  Dr.  Odell.  It  was  a  case  of  retained  pla- 
centa, in  which  general  sepsis  had  developed  before  he 
was  called.  In  spite  of  prompt  extraction  of  the  putrid 
mass,  and  thorough  disinfection,  the  patient  succumbed 
to  acute  sepsis.  Dr.  Odell  has  performed  three  suc- 
cessful laparotomies  during  his  residence  in  Pago 
Pago:  1.  Ovarian  tumor.  2.  Dermoid  of  ovary.  3. 
Kuptured  extrauterine  pregnancy.  Patients  take  anes- 
thetics well,  and  wounds  heal  promptly.  Myofibroma 
of  the  uterus  does  not  appear  to  be  as  common  in  the 
women  of  the  South  Seas  as  is  generally  supposed;  on 
the  other  hand,  lipoma  in  all  its  favorite  localities  is 
very  frequently  met  with  in  both  sexes.  It  will,  in 
conclusion,  interest  the  readers  to  loiow  that  our  island 
in  the  Pacific  has  a  newspaper  in  the  native  language, 
published  every  month  at  government  expense  and  dis- 
tributed gratuitiously  among  the  inhabitants.  Through 
this  medium  they  receive  the  local  news  and  keep  in 
touch  with  the  outside  world. 

AxcKi.AM),  Xew  ZeaLiVMi.  July  2.1. 


NEW  ZEALAND. 

THE    OCEAN    VOYAGE — CLIMATE — NATIVES — AUCKLAND — 
AUCKLAND    HOSPITAL MEDICAL    PROFESSION. 


The  American  has  become  during  the  hist  twenty-five 
years  an  enthusiastic  traveler,  and  the  increasing  pros- 
perity in  our  country  will  only  tend  to  increase  his  de- 
sire to  see  the  outside  world  and  familiarize  himself 
with  the  greatest  of  all  subjects — man — ^his  customs 
and  habits  in  various  parts  of  the  globe,  as  well  as  the 
conditions,  climatic  and  otherwise,  Avhich  influence  his 
physical  and  mental  characteristics.  The  observing 
traveler  will  have  become  aware  that 

"Men's  cluaracters  and  habits  are  not  influenced 
so  much  by  the  peculiarities  of  family  and  race  as 
by  the  physical  features  of  their  native  land  and 
their  mode  of  life — things  b}"  Avhich  we  are  sup- 
ported and  by  which  we  live." — Cicero. 

The  people  of  the  United  States  spend  annually 
$160,000,000  in  touring  the  old  world;  very  few,  in- 
deed, direct  their  steps  westward,  and  we  as  a  nation 
know  very  little  of  New  Zealand,  the  land  of  geysers, 
mountains,  glaciers,  fjords,  and  the  Maoris  of  the  great 
continent  of  Australia,  its  strange  animals,  trees  and 
flowers,  its  vast  plains,  impenetrable  forests,  and  the 
home  of  one  of  the  most  primitive  of  all  races.  The 
American  globe  trotter  usually  selects  the  Japanese 
route.  For  a  summer  trip  the  Australian  route  is  de- 
cidedly the  best. 

VOYAGE   FROM    SAN   FRANCISCO   TO   NEW    ZEALAND. 

The  southwestern  part  of  the  world.  New  Zealand 
and  Australia,  are  now  readily  accessible  to  the  traveler 
by  the  establishment  of  a  regular  steamer  service.  The 
three  sister  ships  of  the  Oceanic  Steamship  Company, 


86  AliOUXD    THE    AVOKLD    VIA    INDIA. 

the  Sierra,  Sonoiiia  and  Ventura,  modern  6,000-horse 
power  steamers,  make  the  trip  regularly  every  three 
weeks.  The  tahle  is  excellent  and  the  service  faultless. 
The  distance  from  San  Francisco  to  Auckland  is  nearly 
6,000  miles,  and  the  time  to  cover  it  17  days.  The 
monotony  of  the  voyage  is  broken  by  making  stops  at 
Honolulu  and  Pago  Pago  long  enough  for  the  passen- 
gers to  get  a  good  glimpse  of  the  tropics,  their  inhabit- 
ants, animal  life  and  products  of  the  soil.  Between 
these  places  is  the  desert  ocean,  and  the  passenger  who 
does  not  know  how  to  improve  his  time  profitably  might 
be  tempted  to  complain  of 

"The  burden  of  the  desert  of  the  sea." — Isaiah  xxi,  1. 

We  never  saw  a  sail  or  puff  of  smoke  on  the  whole 
voyage,  except  in  the  harbors.  The  interested  traveler 
has,  however,  enough  to  see  and  observe.  The  endless, 
trackless  waste  of  the  ocean  in  itself  is  something  won- 
derful to  contemplate,  in  its  various  moods  of  peace  and 
rest,  anger  and  storms.  The  glorious  sunsets  paint 
pictures  on  sky,  sea  and  clouds  that  delight  the  eye  of 
the  most  unappreciative  of  the  wonders  of  nature.  The 
starlit  sky  and  the  silvery  moon  enlighten  the  evenings 
and  shorten  the  long  nights  in  the  tropics.  One  day 
out  from  Honolulu  the  sim  crossed  our  ship,  and  two 
days  before  we  reached  Auckland  the  full  moon,  from 
its  lofty  position,  smiled  directly  down  on  the  very  tips 
of  its  masts.  The  great  crest-covered  furrows  ploughed 
by  the  ship  on  each  side  reminded  one  of  the  speed  with 
which  we  move  on,  and  at  night  hypnotize  and  delight 
the  sense  of  sight  by  their  phosphorescent  illumination 
in  the  form  of  myriads  of  diamonds,  which  come  and 
disappear  in  the  twinkle  of  the  eye.  The  animals  en- 
countered in  the  South  Pacific  are  few,  hence  more 
eagerly  looked  for.  That  daring,  tireless  mariner,  the 
sea-gull,  followed  the  wake  of  the  ship  nearly  the  entire 
distance.  Brown  and  white,  large  and  small,  these 
graceful  flyers  circled   in  the  air.  with  little  effort  on 


^■1•:\V■   ZKALAM).  8. 

tlifii'  pjirt.  (Miiiiiii;;  and  ^oiii-i'  hy  simply  spreading  tlieir 
wings,  tlu'ir  sharp  eyes  fixed  on  the  turbulent  water 
whipped  into  a  diminutive  storm  by  the  revolving  screw, 
patiently  waiting  for  their  time  to  feed  on  the  refuse 
of  kitchen  and  table,  and  the  moment  it  appeared  in 
the  agitated  waters,  with  unerring  aim  would  dash  from 
their  height  with  the  speed  of  an  arrow,  grasp  and 
greedily  devour  the  cherished  morsel.  The  flying  fish, 
single,  in  pairs,  or  in  schools  of  many,  when  the  sea  is 
quiet,  frightened  by  the  approach  of  the  ship  would  dash 
from  their  briny  element  into  the  air  and  make  their 
short  flights  in  gentle  curves,  striking  the  water  at  a 
distance  of  about  thirty  yards,  rebound  and  make  one 
or  two  other  flights,  finally  to  disappear  with  a  splash 
from  whence  they  came.  With  these  things  around 
and  about  you  and  useful  books  to  read,  the  longest  sea 
voya'ge  is  stripped  of  its  monotony.  From  Honolulu  to 
Samoa  the  average  temperature  in  the  cabins  on  the 
port  side  of  the  ship  was  80  to  82  F.  At  one  time  my 
thermometer  registered  100  F.  in  the  sun.  The  south- 
west wind  was  constant.  In  less  than  four  hours  after 
leaving  Samoa  a  cold  breeze  set  in  which  forced  the 
passengers  to  lay  aside  the  white  suits  and  rummage 
their  trunks^  for  clothing  of  a  more  somber  color  and 
heavy  underwear.  That  evening  blankets  were  in  de- 
mand, and  next  day  those  not  used  to  a  colder  climate 
paced  the  deck  in  fur  and  overcoat.  This  sudden 
change  in  the  temperature  reminded  us  that  we  were 
approaching  a  part  of  the  world  where  the  seasons  are 
the  reverse  of  ours. 

From  now  on  the  sea  became  rough,  which,  combined 
with  a  heavy  wind  and  drizzling  rain,  soon  cleared  the 
decks.  At  noon,  July  26,  we  passed  several  barren 
islands,  and  soon  the  rugged,  hilly,  almost  treeless 
coast  of  New  Zealand  was  sighted,  and  at  2  o'clock  we 
reached  the  wharf  of  Auckland.  The  harbor  of  Auck- 
land is  one  of  the  finest  in  the  world.  All  the  navies 
of  the  world  would  find  here  ample  room,  not  only  as 


88  AKOUND    THE    WORLD    VIA    IXDIA. 

a  place  of  safety,  but  enough  space  in  which  to  ma- 
ueuvre. 

CLIMATE. 

We  found  Xew  Zealand  in  the  grasp  of  midwinter, 
however  not  Avith  ice  or  snow,  not  even  frost.  The  grass 
had  lost  its  emerald  green,  and  the  naked  trees  with  de- 
ciduous leaves  were  about  the  only  reminders  of  the 
New  Zealand  winter.  Many  of  the  garden  flowers,  roses 
and  violets,  were  in  full  bloom,  and  the  grassy  slope? 
of  Mt.  Eden  were  checkered  with  a  little  white  flower 
that  peeped  through  the  low  grass,  anxious  to  inform 
the  visitor  that  it  had  survived  the  rigors  of  the  sub- 
tropic  winter. 

The  snowclad  mountains  and  the  extent  of  the  island 
in  a  line  from  south  to  north,  give  to  the  Kew  Zealander 
a  wide  range  of  choice  of  climate.  On  the  whole,  the 
climate  is  mild,  equable  and  agreeable;  extremes  of 
cold  and  heat  are  unknown.  The  perpetual  snow  line 
is  7,500  feet  above  the  level  of  the  sea.  The  great  for- 
o-sts  in  the  southern  part  of  the  islands  secure  an  ade- 
quate rainfall  throughout  the  year.  During  the  sum- 
mer months,  from  October  or  November  to  April  or 
]\Iay,  the  weather  is  as  nearly  perfect  as  can  be  found 
anywhere — days  of  sunshine,  with  pleasant  breezes  and 
cool  nights.  Mt.  Cook.  13,349  feet,  is  the  highest  of  the 
many  mountain  peaks. 

NATIVES. 

The  natives  of  New  Zealand  are  the  Maoris,  a  chival- 
rous, proud,  noble  race.  They  are  Polynesians,  of  the 
same  origin  as  the  inhabitants  of  all  the  islands  of  the 
South  Sea.  Their  physical  and  mental  characteristics 
have,  however,  undergone  marked  changes  since  they 
made  their  first  appearance  in  New  Zealand.  Tasman, 
who  discovered  the  islands  in  1642,  but  did  not  land, 
and  Captain  Cook,  who  visited  them  several  times  be- 
tween  1769   and   1777.  found   them   densely  populated 


Fig.  21. — Maori  women. 


NEW   ZEALAND.  91 

at  that  time,  and  until  subdued  by  the  British  they 
were  hardy,  war-loving  people. 

War  was  a  passion  Avith  them,  but  their  greatest  na- 
tional characteristic  was  their  love  of  the  land.  "Let 
"US  die  for  the  land"  was  their  war  cry  that  resounded 
through  all  the  ages  of  their  possession.  Civilization 
has  made  them  law-abiding  citizens  of  the  colonial 
government  and  loyal  to  the  king,  as  was  shown  during 
the  South  African  war,  when  many  of  them  expressed 
a  strong  desire  to  join  the  British  forces.  The  men  are 
tall,  powerful,  square,  with  a  brown  skin,  jet-black 
eyes,  scanty  beard,  straight  or  slightly  curly  hair,  with 
an  open,  frank  countenance.  The  women  are  well  built, 
with  copious  hair,  worn  in  flowing  tresses  or  pompa- 
dour, and  many  of  them  with  handsome  features  when 
young.  There  are  about  20  per  cent,  more  males  than 
females.  The  climate  of  New  Zealand  has  made  its 
impression  on  this  race.  They  had  to  protect  them- 
selves against  cold  by  clothing  and  closed  habitations. 

The  New  Zealand  flax  or  hemp  (Phormium  tenax), 
a  liliaceous  plant,  from  the  leaves  of  which  the  fibers 
are  obtained,  are  from  3  to  9  feet  long  and  from  2  to 
3  inches  broad,  furnished  them  with  material  for  tlie 
texture  of  their  garments,  as  well  as  the  feathers  of 
birds  and  the  skin  of  fur-bearing  animals.  The  scarcity 
of  tropical  fruits  and  starch-yielding  tubers  made  the 
struggle  for  life  more  difficult  than  in  the  more  favored 
islands  of  the  South  Pacific,  something  which  could  not 
fail  in  improving  their  physical  condition,  and  in  devel- 
oping their  mentality.  The  Maoris  have  a  taste  for  art, 
as  is  amply  shown  by  their  rude  wood  carvings  and  the 
architecture  of  their  houses.  Tattooing  was  formerly 
extensively  practiced,  but  the  operation  is  performed 
in  an  entirely  different  manner  than  in  Samoa  and 
Tahiti.  As  the  natives  have  always  worn  clothes  of 
some  kind  they  select  the  face,  the  most  exposed  part 
of  the  body,  for  the  tattooing.  The  chiefs  undergo  the 
most  elaborate  process  of  the  tattooer's  art.     With  a 


92  AROUXD    THE   WORLD    VIA    INDIA. 

sharp  shell  Hues  and  scrolls  are  cut  in  the  superficial 
parts  of  the  skin,  always  radiating  from  the  nose,  and 
into  these  scratches  the  pigment  is  rnbbed  and  perma- 
nentl)'  deposited.  The  women  only  tattoo  the  lower 
lip  and  chin  in  straight  lines.  Christianity  has  taken 
the  place  of  paganism,  bnt  is  not  held  with  mnch  fervor 
by  the  people.  Pagan  customs  and  superstition  remain. 
Some  Maoris  have  taken  to  farming  and  the  profes- 
sions, but  the  bulk  of  the  race  is  living  in  dull  idleness, 
depending  on  the  liberal  government  for  their  support. 
The  young  people  realize  the  advantages  of  an  educa- 
tion, and  are  profiting  by  the  schools  located  in  all  of 
the  settlements,  as  in  it  they  see  the  only  means  that 
will  prevent  complete  extinction  of  their  race.  Like  all 
Polynesians,  the  Maoris  have  brought  their  tribute  to 
the  altar  of  civilization.  The  acute  infectious  diseases, 
syphilis  and  tuberculosis,  brought  to  their  islands 
by  the  whites,  have  reduced  the  population  num- 
bering hundreds  of  thonsands,  to  something  like 
40,000.  In  1891  the  native  population  numbered 
43,642,  of  whom  2,119  were  half-castes..  In  1896  the 
total  population  of  iSTew  Zealand  was  743.214,  of  whom 
39,854  were  Maoris  and  half-castes.  Improved  sanitary 
measures  and  a  better  appreciation  of  hygiene  by  the 
natives  have  contributed  much  in  diminishing  the  mor- 
tality among  the  natives,  and  will,  it  is  to  be  hoped, 
prevent  the  extinction  of  this  noble  race. 

THE  CITY  OF  AUCKLAND. 

From  the  harbor  the  city  of  Auckland,  with  its  over 
60.000  inhabitants,  presents  a  charming  sight.  It  is 
spread  out  over  a  large  surface  encircling  the  capacious 
harbor  and  perched  on  many  hills.  The  two-story 
houses  and  cottages  are  bnilt  of  brick  or  wood,  and 
many  of  the  business  houses  in  Queen  Street,  the  main 
thoroughfare,  are  solid  structures  of  stone  or  brick  and 
cement.  Most  of  the  streets  have  asphalt  pavements, 
and  are  kept  scrupulously  clean.     The  electric  lighting 


NEW   ZEALAND.  93 

and  tramway  convoiiieneos  com])aic'  well  with  any  of 
our  modern  lively  western  cities.  The  many  clmrches, 
excellent  schools,  capacious  hospital,  mnscnm  and  pub- 
lic library  speak  well  for  the  intellectual  life  of  the 
island  city.  The  drive  to  Mt.  Eden,  with  its  bowl- 
shaped  extinct  crater,  within  the  limits  of  the  city,  is 
one  of  great  scenic  beauty.  I  made  this  tour  in  com- 
pany with  Dr.  Lewis  in  his  automobile.  I  noticed 
when  we  made  a  short  stop  at  the  foot  of  the  mountain 
that  Dr.  Lewis  and  his  coachman  held  a  short  consul- 
tation, the  significance  of  which  I  did  not  understand 
at  the  time.  Dr.  Lewis  steered  the  French  machine. 
The  ascent  was  slow,  and  when  we  came  to  a  few  yards 
of  steep  grade  the  coachman  lent  aid  to  the  quivering 
vehicle  by  a  vigorous  vis-a-iergo  until  the  obstacle  was 
overcome,  when  the  rest  of  the  ascent  was  made  with- 
out any  further  difficulty.  When  we  reached  the  sum- 
mit the  doctor  and  coachman  shook  hands,  and  the 
former  said  in  a  triumphant  tone,  ^'I  told  you  so."  It 
seems  that  there  had  been  some  misgivings  concerning 
the  possibility  of  accomplishing  this  feat,  as  the  doctor 
had  never  attempted  it  before.  His  faith  in  the  power 
of  his  machine  had  been  vindicated.  The  view  from 
the  summit  of  the  mountain  is  inspiring.  The  dizzy 
depth  of  the  crater  and  the  panorama  all  around  leave 
deep  and  permanent  impressions  on  the  memory  of  the 
astonished  tourist;  the  sight  of  the  first  is  awe  inspir- 
ing, the  contemplation  of  the  surrounding  scenery 
pleasing  and  full  of  surprises.  From  the  summit 
twenty  other  extinct  craters  can  be  seen,  and  the  wide 
expanse  of  the  Pacific  on  both  sides.  The  well-painted 
Avooden  houses  and  the  pale  red  brick  houses,  with  their 
silvery  roofs  of  corrugated  iron,  and  the  harbor,  with  its 
vessels,  looked  like  a  toy  city  made  for  the  amusement 
and  instruction  of  children.  Eucalyptus  and  pine  trees, 
the  lovely  gardens  attached  to  nearly  all  the  houses, 
and  the  straight^  clean  streets  added  much  to  the  beauty 
of  this  fairy  scene.  The  city  is  supplied  with  pure  water 


94  AROUND    THE    WORLD    VIA    INDIA. 

from  the  mountains,  and  a  system  of  sewerage  is  now 
under  completion.  On  an  average  100  cases  of  typhoid 
fever  occur  annually.     Malaria  is  almost  unknown. 

THE  AUCKLAND  HOSPITAL. 

Auckland  has  only  one  public  hospital,  the  Auckland 
Hospital.  It  is  supported  by  appropriations  made  by 
the  general  government  and  the  city.  The  main  build- 
ing was  built  about  fifty  years  ago.  It  is  built  on  the 
summit  of  a  high  hill,  from  which  a  splendid  view  of 
the  harbor  and  city  can  be  obtained.  Seen  from  the 
harbor  it  is  one  of  the  most  conspicuous  landmarks  of 
the  city.  The  city  has  set  aside  for  it  a  large  tract  of 
land,  and  the  part  around  the  buildings  is  well  laid  out 
in  drives  and  walks,  and  ornamented  by  trees,  flowering 
shrubs  and  flowers.  The  main  building,  of  brick  and 
cement,  is  three  stories  high,  with  large  wards,  well 
lighted  and  ventilated.  A  few  years  ago  a  Mr.  Coatley 
donated  to  the  hospital  the  munificent  sum  of  $160,000, 
out  of  which  four  brick  pavilions  for  women  and  child- 
ren have  been  built,  and  $15,000  is  now  being  spent 
in  the  construction  of  a  modern  operating  room  and 
equipments  for  the  same.  This  operating  room,  now 
nearing  completion,  will  be  flushed  daily  from  above, 
and  the  skylight  of  a  double  glass  roof  is  constructed  in 
such  a  manner  that  the  light  will  be  concentrated  at  a 
place  corresponding  with  the  location  of  the  operating 
table.  Dr.  John  C.  Collins,  the  medical  superintendent, 
took  great  pains  to  describe  this  feature  of  the  operat- 
ing room,  as  well  as  its  ventilation.  By  the  use  of  an 
electric  apparatus  the  air  of  the  room  can  be  exhausted 
at  any  time  it  becomes  contaminated.  The  operating 
room  used  at  the  present  time  is  on  the  first  floor,  but 
is  inadequate  for  modern  requirements.  The  medical 
staff  is  composed  of  three  physicians,  three  surgeons, 
one  oculist  and  aurist,  no  gynecologists  and  no  obstet- 
ricians. The  hospital  proper  and  pavilions  can  accom- 
modate 210  patients.    Patients  with  means  are  required 


NEW    ZEALAND. 


95 


to  pay,  the  amount  depending  entirely  on  their  means. 
A  charming  feature  in  the  wards  of  this  hospital  is  an 
abundance  of  fresh-cut  flowers  on  high,  narrow,  long 
tables  at  the  foot  of  the  beds  in  constant  sight  of  the 
patient  when  awake.  The  hospital  has  its  own  training 
school  for  female  nurses,  with  an  attendance  of  64  at 
the  present  time.  They  are  in  training  for  three  years, 
but  receive  a  small  compensation  after  three  months. 
Among  the  interesting  surgical  cases  shown  by  Dr. 
Collins  were  the  following:  A  Maori  who,  by  the  acci- 
dental discharge  of  a  shotgun  he  was  handling,  shot 
away  tlic  larger  part  of  the  liody  of  the  loft  side  of  the 


Fig.    22. — Auckland    Hospital. 

lower  jaw.  Edema  of  the  larynx  was  threatened,  and 
a  tracheotomy  was  made.  At  the  end  of  twenty-four 
hours  the  tube  was  removed,  and  although  the  left  side 
of  the  face  remained  greatly  swollen,  he  is  improving 
rapidly.  Several  cases  of  compound  fracture;  resec- 
t'on  of  cecum  for  tuberculosis:  gastroenterostomy  for 
stricture  of  the  pylorus ;  extensive  fracture  of  the  skull 
in  a  l)oy,  for  which  trephining  was  performed.  On  an  av- 
erage about  100  laparotomies  are  performed  in  the  hos- 
pital every  year  by  the  different  attending  surgeons. 
This  comparatively  small  number  of  abdominal  opera- 
tions, however,  does  not  represent  the  bulk  of  this  kind 
of  work  done  in  the  citv,  as  onlv  tlie  attendinaf  staff  is 


9G  AROUND    THE    WOliLU    VIA    INDIA. 

pennitted  to  operate  in  this  institution,  and  many  of 
these,  and  all  other  physicians  perform  their  operations 
on  private  patients  at  their  homes,  or  in  one  of  a  nnm- 
her  of  little  private  hospitals  conducted  by  nurses. 
There  seems  to  be  no  unanimity  among  the  surgeons  in 
the  use  of  anesthetics  and  suturing  material.  Chloro- 
form, ether  and  A.  C.  E.  mixture  are  used  as  anes- 
thetics, and  silk,  silkworm  gut,  catgut  and  kangaroo 
tendon  as  suture  material  according  to  the  preference 
of  the   different   operators. 

THE    MEDICAL    PHOFESSIOX. 

I  had  abundant  opportunity  to  experience  that  the 
medical  profession  of  Auckland  is  cordial  and  hospit- 
able. Dr.  Edward  W.  S.  Sharman,  the  quarantine  phy- 
sician of  the  port,  after  completing  his  inspection  of 
the  steamer,  took  me  ashore  in  his  steam  launch,  and 
from  there  directly  to  Dr.  T.  Hope  Lewis,  the  most 
prominent  surgeon  of  the  city.  To  these  two  gentle- 
men, who  gave  me  their  whole  time  during  the  entire 
afternoon,  I  am  greatly  indebted  for  what  I  saw  and 
learned  in  their  city.  There  are  40  practitioners  in  Auck- 
land. There  is  only  one  specialist  for  the  eye  and  ear. 
All  of  the  physicians  do  their  own  operating,  including 
all  kinds  of  gynecologic  work.  Dr.  Lewis  is  the  only 
one  who  is  gradually  leaving  general  practice,  and  will 
soon  devote  himself  exclusively  to  surgery.  The  fees 
in  Auckland  are  not  high.  Visits  are  charged  for  ac- 
cording to  the  |)atient's  means,  from  Tac  to  $3.50.  The 
maximum  figure  is  very  seldom  reached.  For  any  ca])- 
ita]  operation  $250  is  regarded,  even  l)y  the  wealfliy,  as 
a  very  lai'ge  fee,  and  most  of  the  diftieult  operations 
aie  paid  for  at  the  rate  of  $100.  Most  of  the  physicians 
are  graduates  of  English  and  Scotch  universities,  and 
consequently  their  practice  of  medicine  and  surgery  rep- 
resents the  teachings  of  British  authorities.  They  are 
all  members  of  the  British  ^ledical  Society,  and  depend 
for  th(>  current  medical   literatui'e  hir^elv  on  its  official 


NEW   ZEALAND.  97 

organ,  the  British  Medical  ■Journal.  TJie  New  Zealand 
hraiicli  meets  once  a  year,  and  the  city,  or  local  brancli, 
monthly.  These  meetings  are  well  attended,  and  the 
transactions  represent  the  clinical  and  scientific  work 
of  its  members. 

Sydxky,  Australia.  July  ."^O.  1004. 


AUSTIN  ALIA. 

ITS   CLIMATE.  DISEASES,  PEOPLE.  NATIVES,   SYDNEY,   HOS- 
PITALS, MEDICAL  PROEESSIOX. 


The  voyage  from  Auckland  to  Sydney  takes  four 
days.  The  first  two  days  we  encountered  a  strong 
northwesterly  gale  which,  on  shifting  to  southwest, 
brought  with  it  the  cold  breath  of  the  south  polar  re- 
gion. Sailing  in  a  southwestern  direction  the  cold 
gradually  increased  until  we  entered  the  magnificent 
harbor  of  Sydney,  Saturday  evening,  July  30.  It  was 
soon  after  leaving  Auckland  that  it  became  apparent 
that  we  were  in  the  vicinity  of  an  entirely  new  world, 
with  strange  animals,  trees,  plants  and  flowers,  by  the 
appearance  of  a  rare  and  strange  bird — the  albatross. 
About  half  a  dozen  of  these  giant  sea-gulls  accompanied 
us  from  coast  to  coast,  but  carefully  avoided  the  har- 
bors. It  is  a  magnificent  bird  with  snow-white  body, 
yellow  straight  bill,  the  upper  part  of  which  at  its 
distal  end  is  bulbous  and  its  tip  sharply  curved  down- 
ward, overlapping  the  lower;  the  enormous  wings, 
measuring  from  tip  to  tip  from  eight  to  twelve  feet, 
are  white  underneath,  and  the  upper  surface  brown  with 
the  exception  of  its  inner  fourth,  which  is  also  white. 
These  birds  live  on  waste  material  which  is  thrown 
overboard  by  the  passing  vessels.  They  fly  with  and 
against  the  wind  nearly  with  the  same  velocity  and 
with  very  little  effort  on  their  part,  three  or  four  strokes 
of  their  immense  wings  sufficing  to  start  their  graceful 
sailing  movements,  and  by  poising  their  body  and  wings 
in  proper  attitude  they  ascend,  descend  and  make  all 
kinds  of  curves  and  circles  with  little  if  any  effort  until 
a  few  active  movements  of  the  wings  again  become  nec- 
essary to  keep  up  the  necessary  momentum.  They  are 
very  fast  flyers,  and  multiply  many  times  the  distance 


100  AROUND    THE    WORLD   VIA    INDIA. 

made  bv  the  steamer  in  their  ceaseless  to-and-fro  flights 
in  search  for  tlie  very  irregular  and  often  scant}'  food 
supply. 

Many  people  are  still  under  the  erroneous  belief  that 
Australia  is  an  island,  and  few,  indeed,  have  a  correct 
conception  of  the  magnitude  of  this  great  continent, 
which  probably  emerged  from  the  bosom  of  the  Paciiio 
Ocean  before  the  other  continents  saw  daylight.  It  is 
nearly  as  large  as  the  United  States,  inclusive  of 
Alaska.  Australia  was  first  discovered  by  the  Dutch 
and  Spaniards  in  1601-1606,  and  Captain  Cook  visited 
it  in  1770,  entering  Botany  Ray,  near  where  Sydney  is 
now  located.  April  28,  where  he  landed  and  took  pos- 
session in  the  name  of  King  George  III.  For  a  long 
time  England  used  it  as  a  penal  colony.  There  is  per- 
haps no  other  country  that  presents  to  the  stranger 
more  characteristic  features  than  Australia.  Many 
things  are  the  reverse  to  those  who  live  ■  north  of  the 
equator.  When  we  have  summer  it  is  winter  here.  The 
tropical  part  of  Australia  is  in  the  north  and  the  frosts 
and  occasionally  a  flurry  of  snow  in  the  south.  The 
crescent  of  the  moon  appears  to  us  turned  around.  The 
animals  are  strange.  It  is  the  home  of  the  strangest 
of  all  known  animals,  the  duck-bill  platypus  (Ornithor- 
hi/nrhus  paradoxus) ,  which  forms  the  connecting  link 
between  quadrupeds  and  birds.  It  is  about  two  feet  in 
length,  has  a  flat  black  bill,  webbed  feet  and  body  cov- 
ered with  a  brown,  silky  fur  skin  like  a  beaver ;  it  lays 
eggs  and  supplies  the  young  with  milk  from  its  breasts. 
Australia  is  also  the  land  where  the  giant  emu  {Dro- 
nans  norw-JiolJandia;)  lives,  a  bird  with  only  rudimen- 
tary wings  and  in  size  as  large  as  the  ostrich  of  Africa. 
Among  the  other  strange  animals  there  are  the  kanga- 
roo, the  wallaby,  the  kangaroo  rat,  flying  fox,  blind 
snakes  and  a  small  species  of  bear  not  larger  than  a 
guinea-pig,  and  the  cassoway,  a  turkey  as  large  the  emu, 
and  more  than  sixty  varieties  of  parrots.  The  vegetable 
kingdom  is  characterized  by  its  great  variety.     The  vast 


AUSTRALIA.  101 

forests  arc  coiiiposed  of  ciicalyptiis  trees  wliich  are 
evergreen,  but  instead  shed  tlicir  bark  annually;  400 
varieties  of  this  tree  liave  been  described;  more  than 
10.000  of  its  indigenons  plants  have  been  classified.  The 
great  variety  of  the  fanna  and  flora  of  Australia  alone 
should  be  a  sufficient  inducement  for  all  those  who  take 
interest  in  natural  history  to  visit  this  land  so  full  of 
nature's  strangest  productions,  all  of  which  seem  to 
point  to  the  great  age  of  this  part  of  the  world. 

THE  KANGAROO. 

The  kangaroo  is  a  striking  freak  of  Australia's  fauna. 
For  the  purpose  of  increasing  its  speed,  its  only  de- 
fense, nature  has  supplied  this  animal  with  a  fifth  leg 
in  the  form  of  a  long  and  powerful  tail.  Shorten  the 
ears  of  one  of  our  jack-rabbits  one-half,  lengthen  the 
hind  legs  four  times  and  add  the  tail  of  a  kangaroo  and 
it  would  be  converted  into  a  kangaroo  on  a  small  scale. 
This  animal  has  a  special  interest  for  the  surgeon,  as 
the  numerous  delicate  tendons  of  its  tail  have  supplied 
a  good  substitute  for  catgut  as  a  suturing  and  ligature 
material.  For  more  than  twenty  years  my  friend.  Dr. 
H.  0.  Marcy  of  Boston,  has  expounded  the  virtues, 
advantages  and  use  of  the  kangaroo  tendon  in  surgery, 
and  through  his  influence  it  has  become  a  very  popular 
substitute  for  catgut  in  the  practice  of  many  American 
surgeons.  I  was  somewhat  astonished  to  find  that 
American  surgeons  entertain  a  more  favorable  view  of 
the  utility  of  the  kangaroo  tendon  than  their  Australian 
colleagues.  Some  of  the  latter  never  use  it,  some  oc- 
casionally, and  very  few,  if  any,  use  it  exclusively.  It 
will  interest  the  devotees  of  the  kangaroo  tendon  liga- 
ture and  suture  to  loiow  that  what  they  have  been  using 
is,  as  a  rule,  not  the  tendon  of  the  kangaroo,  but  of  the 
different  species  of  wallaby.  The  kangaroo  tendon  is 
very  coarse,  at  least  the  size  of  an  old-fashioned  knit- 
ting needle,  altogether  too  large  for  general  use.  The 
wallaby  is  a  very  much  smaller  animal  of  the  kangaroo 


102  AROUND    THE   WORLD   VIA    INDIA. 

family  and  yields  a  much  finer  material.  There  are 
three  large  species  of  kangaroo — the  red  kangaroo 
(Macropiis  rufus),  the  great  gray  kangaroo  {Macropus 
gigantens) ,  Bennett's  tree  kangaroo  {Dentrologits  Ben- 
nettiamis).  The  wallabys  that  furnish  the  tendon  sup- 
ply are  represented  by  Parry's  wallaby  (Macropus 
Parrei),  agile  wallaby  {Macropus  agilis),  brush-tailed 
rock  wallaby  (Petrogale  pencillata),  black  wallaby 
(Macropus  rohustus) .  The  rat  kangaroo  has  a  tail  like 
a  kangaroo  and  its  fine,  extremely  delicate  tendons, 
I  am  informed,  have  been  used  by  some  ophthalmic 
surgeons.  The  real  kangaroo  has  become  quite  rare, 
as  their  skins  are  valuable  and  the  price  paid  to  market 
hunters  was  a  sufficient  inducement  for  them  to  carry 
on  a  war  of  extermination.  For  the  same  reason  the 
wallabys  have  also  become  much  less  numerous.  These 
animals  are  now  protected  during  certain  seasons  of  the 
year,  which  will,  it  is  to  be  hoped,  prevent  them  shar- 
ing the  same  fate  that  we  meted  out  to  our  buffalo. 
The  tendons  are  obtained  by  divesting  the  tail  of  its 
skin,  cutting  off  its  tip,  grasping  each  tendon  with  for- 
ceps and  extracting  it  with  a  jerk.  The  proximal  end 
of  the  evulsed  tendon  is  a  little  larger  and  more  flat- 
tened than  its  distal  end. 

CLIMATE. 

The  Australian  has  a  wide  range  from  which  to  make 
a  selection  of  climate,  as  it  is  influenced  by  latitude, 
elevation  and  distance  from  the  coast.  Floods  and 
droughts  are  the  bad  things  which  have  seriously  inter- 
fered with  the  continuous  prosperity  of  the  country, 
and  they  likewise  have  a  decided  influence  on  the  cli- 
mate. The  northern  part  of  Australia  is  tropical  and 
has  a  tropical  climate,  and  the  vast  forests  secure  for 
that  section  of  the  country  an  abundant  rainfall  and  a 
luxurious  vegetation.  In  the  vast  dry  plains  of  the  in- 
terior the  heat  during  the  summer  months  is  intense: 
here  the  thermometer  has  been  known  to  register  as 


AUSTRALIA.  103 

high  as  140  degrees  F.  The  Australian  Alps  consist 
of  a  range  of  mountains  in  the  southeastern  part  of  the 
country  called  Warragong  by  the  natives.  The  highest 
peak  is  Mt.  Kosciusko,  which  rises  to  an  elevation  of 
7,176  feet.  This  forest-clad  mountain  range  has  a  de- 
cided influence  on  the  climate  of  the  surroimding  coun- 
try, breaking  the  force  of  the  icy  winds  from  the  south 
in  winter  and  the  land  breezes  from  its  summit  moder- 
ating the  heat  during  the  summer  months.  The  cli- 
mate of  Sydney  is  very  much  like  that  of  Naples,  with  a 
mean  annual  temperature  of  from  58  to  62  degrees  F. 
Frosts  in  winter  are  common;  the  highest  temperature 
in  summer  does  not  exceed  104  degrees  F.  At  Mel- 
bourne, 500  miles  south  of  Sydney,  very  thin  pellicles 
of  ice  are  sometimes  seen  during  midwinter  on  small, 
quiet  pools  of  water;  the  summers  are  decidedly  cooler 
than  in  Sydney.  At  Sydney  the  average  annual  rainfall  is 
over  49  inches,  and  during  the  summer,  from  Decem- 
ber to  the  beginning  of  March,  the  sky  is  cloudless  and 
the  nights  generally  cool,  sufficiently  so  to  remind  the 
people  of  the  use  of  woolen  blankets.  For  the  Ameri- 
can visitor  winter  is  the  proper  time  to  see  Australia, 
as  he  will  then  escape  our  summer  heat  and  will  enjoy 
the  Australian  winter  with  its  flowers  and  invigorating 
cool  breezes. 

PREVAILING  DISEASES. 

With  few  exceptions  the  prevailing  diseases  of  Aus- 
tralia are  the  same  as  of  our  middle  states.  It  has  es- 
caped the  ravages  of  cholera.  Sydney  recently  has  had 
a  number  of  cases  of  bubonic  plague,  but  the  rigid  san- 
itary precautions  resorted  to  by  the  board  of  health 
have  succeeded  in  stamping  out  the  disease.  Malaria 
is  met  with  only  in  the  tropical  part  of  the  country. 
Pneumonia  of  a  very  virulent  tjrpe  occurs  most  fre- 
quently during  the  winter  season.  Acute  articular  rheu- 
matism is  quite  rare.  Influenza,  scarlatina  and  measles 
make  their  appearance  from  time  to  time.    Typhoid  fe- 


104  AUOrXD    THE    AVOKLD   VIA    INDIA. 

ver  appears  to  be  more  frequent  in  the  country  and  vil- 
lages than  in  the  large  cities,  as  the  latter  have  an  ex- 
cellent water  supply.  At  Melbourne  this  disease  is 
most  prevalent  during  the  holiday  season,  when  the 
people  leave  the  city  for  their  vacation  and  live  in 
the  country  towns,  where  the  danger  of  infection  from 
contaminated  water  is  much  greater.  Isolated  cases 
occur  in  the  cities  and  can  usually  be  traced  to  infected 
wells,  which  are  still  in  use  in  parts  of  the  cities  that 
remain  outside  of  the  reach  of  the  regular  water  sup- 
ply. The  skill  of  the  medical  men  is  well  shown  by  the 
very  low  mortality  which  attends  this  disease  and  which 
does  not  exceed  6  per  cent.  Prof.  F.  D.  Bird  has  oper- 
ated on  three  cases  of  typhoid  fever  in  which  a  fatal 
termination  from  sepsis  was  imminent.  He  opened  the 
abdomen.  Avhere  he  found  a  small  quantity  of  serum, 
flushed  with  a  hot  saline  solution,  closed  the  wound  and 
had  the  satisfaction  of  saving  all  of  them,  marked  im- 
provement being  noticed  as  soon  as  the  patients  recov- 
ered from  the  immediate  effect  of  the  operation. 

Tuberculosis  of  the  lungs,  joints,  bones  and  lymphatic 
glands  is  met  with  in  about  the  same  frequency  a?  with 
us.  Leprosy  prevails  to  some  extent  in  Sydney  and  its 
vicinity.  There  are  at  present  17  cases  in  an  isolation 
hospital  on  the  coast  at  Botany  Bay.  several  miles  from 
the  city.  If  a  patient  affected  with  leprosy  has  sufficient 
means  to  support  himself  in  a  house  sufficiently  iso- 
lated from  other  habitations  he  is  not  molested:  if 
this  is  not  the  case  he  is  compelled  to  seek  the  shelter 
of  the  "leprosery."  Although  actinomycosis  is  quite  a 
frequent  affection  among  cattle  it  is  almost  unlmown 
in  man.  Blastomycosis  is  very  rarely  seen.  ISTot  a 
single  case  of  hydrophobia  has  ever  been  seen  in  Aus- 
tralia, although  it  has  a  large  dog  population,  and  the 
dingo  or  wild  dog  is  numerous,  as  well  as  other  ani- 
mals capable  of  transmitting  this  disease.  Tetanus  is 
not  more  common  than  with  us.  In  every  large  hos- 
pital from  two  to  four  cases  are  treated  annually.     In 


AUST1L\LIA.  105 

the  acute  form  of  the  disease  antitetanic  serum  has 
been  found  absolutely  worthless  as  a  curative  agent. 
Hydatids  are  very  common  in  the  southern  pai't  of 
Australia,  Adelaide  and  Sydney  furnishing  the  largest 
percentage.  The  physicians  attribute  the  disease  to  the 
drinking  water.  It  affects  most  frequently  the  liver 
and  lungs,  but  spares  none  of  the  internal  organs.  Op- 
erations on  the  brain  for  hydatid  cysts  figure  in  almost 
every  hospital  report.  In  all  of  the  museums  may  be 
seen  beautiful  specimens  of  hydatids  of  the  bones  ob- 
tained by  operation  or  postmortem  specimens  illustra- 
tive of  the  extensive  destruction  of  the  entire  shaft  of 
the  large  long  bones.  It  is  also  frequently  found  in  the 
fascia  and  omentum.  The  disease  is  very  rare  in 
Queensland,  resembling  the  geographic  distribution  of 
the  disease  in  G-ermapy,  where  it  is  very  common  in  the 
northern  part  and  rare  in  the  southern.  It  has  been  ob- 
served in  children  from  3  to  4  years  old.  It  pursues  a 
more  rapid  course  in  the  young  than  in  the  aged.  Its 
course  varies  in  different  individuals.  It  may  become 
latent  when  the  cysts  shrink  and  the  symptoms  subside. 
As  the  disease  is  often  multiple,  more  especially  in  the 
liver  and  omentum,  a  number  of  operations  may  be- 
come necessary,  as  the  surgeons  have  learned  by  expe- 
rience that  it  is  not  wise  to  undertake  too  much  at  one 
time.  Dt.  Bird  operated  on  a  patient  suffering  from 
hydatids  of  the  omentum  nine  times  before  he  was  able 
to  eliminate  all  the  cysts.  The  .^■-^ay  never  fails  in 
locating  cysts  affecting  the  upper  surface  of  the  liver ; 
this  diagnostic  resource  invariably  yields  a  negative  re- 
sult when  the  under  surface  is  affected.  The  methods 
employed  in  operating  for  hydatid  cysts  of  the  liver 
are  not  uniform.  Dr.  Bird  cuts  dovm  on  the  cyst, 
makes  a  free  incision,  inserts  the  index  finger,  brings- 
up  the  margins  of  the  cut  and  stitches  them  to  the 
external  wound,  extracts  the  lining  membrane  and 
drains.  In  operating  for  a  cyst  on  the  upper  surface 
of  the  liver  he  resects  a  short  piece  of  the  eighth  rib 


10(i  AKOUXD  THE   WOKl.D  VIA  INDIA. 

near  the  costal  cartilage  and  through  tliis  wound  deals 
with  the  cyst  in  a  similar  manner.  He  always  drains. 
Dr.  Fiaschi  of  Sydney,  on  the  other  hand,  is  in  favor 
of  snturing  the  wound  at  once,  without  drainage.  In 
nine  cases  he  was  obliged  only  once  to  reopen  the  wound. 
At  the  Children's  Hospital  in  Melbourne  it  has  been 
observed  that  in  90  per  cent,  of  the  cases  of  hydatid 
cysts  operated  on  an  urticaria  develops  in  from  a  few 
minutes  to  two  hours  after  the  operation,  which  disap- 
pears in  the  course  of  from  one  to  two  days  and  which 
is  attributed  to  an  intoxication  by  tlie  contents  of  the 
cyst  absorbed  from  the  woimd  surfaces  or  the  peritoneal 
cavity.  The  contents  of  monocysts  are  much  more  viru- 
lent than  cysts  which  contain  daughter  cysts.  In  rare 
cases,  after  tapi:)ing  or  operation, .  speedy  death  from 
this  cause  takes  place;  tapping  has  consequently  been 
abandoned. 

THE   PEOPLE. 

Most  of  the  original  settlers  of  Australia  came  from 
England,  Scotland  and  Ireland.  These  people  have  con- 
served their  habits  and  customs  to  a  large  extent,  but 
in  the  course  of  time  a  new  generation  has  gTown  up 
whose  methods  of  life  have  been  molded  by  climate, 
occupation  and  environments.  The  English,  Scotch 
and  Irish  accents  have  not  suffered  on  Australian  soil : 
if  anything,  they  have  become  accentuated,  more  espe- 
cially the  English.  This  accent  is  bad  enough  in  Lon- 
don, but  is  worse  here.  In  rapid  conversation  some 
words  are  unintelligible  to  the  American.  It  does  not 
take  long  for  the  stranger  to  find  this  out.  as  all  he  has 
to  do  is  to  tackle  one  of  the  big  policemen  and  ask  him 
for  directions  to  find  a  certain  street  or  place  of  busi- 
ness, and  he  will  have  to  listen  very  attentievly  to  in- 
terpret his  brogue.  The  real  Australian  is  determined 
to  7nake  the  best  of  the  present  and  enjoy  life.  His 
desire  for  great  wealth  is  a  very  moderate  one,  and  he 
will  not  sacrifice  his  personal  comfort  to  obtain  it.     He 


AUS'll!  AMA.  107 

is  satisfied  with  an  iiuoinc  thai  will  iiisuiv  for  him  an 
easy  oxistencc  and  the  cherished  jx'i'sonal  com  torts.  He 
agrees  witli  Juvenal  is : 

"Wretched  is  the  <>nar(lianship  of  a  lar?(>  fortune." 

Yoli  will  fail  to  find  here  the  careworn,  determined 
faces  that  throw  a  gloom  over  the  restless  throngs  that 
crowd  the  streets  of  Chicago  and  other  great  American 
business  centers.  The  Australians  are  excessively  fond 
of  outdoor  sport.  Men  and  women,  young  and  old.  are 
equally  determined  to  throw  away  the  cares  of  life  as 
often  as  possible  and  enter  with  heart  and  soul  into 
the  enjoyment  of  all  sorts  of  outdoor  sports.  Every  Sat- 
urday noon  business  is  suspended  and  the  whole  after- 
noon is  devoted  to  pleasure.  Yachting  races,  baseball, 
golf  and  cricket  are  the  most  popular  outdoor  amuse- 
ments. On  the  Saturday  I  was  in  Sydney  30,000  people 
attended  a  game  of  baseball,  and,  as  a  yacht  race  was  go- 
ing on  at  the  same  time  and  the  many  events  elsewhere 
were  well  patronized,  it  is  evident  that  nearly  every  fani- 
ilv  contributed  its  share  to  the  vast  outdoor  crowds.  Sun- 
day is  respected  as  a  day  of  rest.  All  shops  and  saloons 
are  closed.  In  the  morning  the  churches  are  filled  to 
overflowing  and  during  the  hours  of  worship  all  tram- 
cars  come  to  a  standstill.  In  the  afternoon  the  houses 
are  deseVted  and  the  people  congregate  in  the  many 
public  parks,  botanical  and  zoological  gardens.  The 
Public  Domain,  across  the  street  from  the  Botanical 
Garden,  is  the  place  for  the  stranger  on  Sunday  after- 
noon if  he  is  desirous  to  obtain  a  good  idea  of  Australian 
life.  On  the  Sunday  I  visited  this  park,  which  includes 
about  forty  acres,  I  found  a  moving  sea  of  human 
beings,  in  the  center  of  which  a  military  band  played 
martial  music.  A  short  distance  from  the  periphery 
of  this  immense  gathering  were  smaller  groups  in  all 
directions.  The  first  one  I  approached  was  an  old- 
fashioned  Methodist  exhortation  meeting,  with  a  leader 
on  one  side  of  the  small  open  space.     After  each  stir- 


lOS  AROUXD  THE  WORLD  VIA  INDIA. 

ring  song  someone  would  step  forward  and  in  a  few 
words  relate  his  religious  experience  and  encourage 
others  to  do  the  same.  Almost  within  hearing  distance 
of  these  revivalists  was  a  much  larger  crowd  listening 
to  a  fiery  political  speech,  the  subject  of  which  was 
the  pending  election.  In  the  middle  of  the  next  group, 
and  it  was  not  a  small  one,  a  tall,  lean,  long-bearded 
man  was  discoursing  on  personal  magnetism,  illustrat- 
ing his  smooth  talk  with  crudely  drawn  pictures.  He 
explained  to  the  gaping  men,  young  and  old,  the  mys- 
teries of  love  and  how  to  prevent  shipwrecks  in  the 
matter  of  the  selection  of  a  partner  for  life.  He  had 
fathomed  the  human  heart  to  its  very  depth  and  evi- 
dently had  his  share  of  this  world's  experience.  For  the 
time  being  he  gave  his  advice  free  and  liberally,  but 
undoubtedly  at  the  end  of  his  harangue  he  supplied  his 
audience  with  his  address  so  that  they  would  have  no 
difficulty  in  finding  him  to  obtain  further  details.  Sev- 
eral fake  physicians  were  expounding  the  virtues  of 
their  specific  remedies,  which  would  cure  all  kinds  of 
chronic  diseases  which  still  baffle  the  skill  of  the  medi- 
cal profession.  These  men  had  their  stuff  with  them 
and  were  lining  their  pockets  with  silver.  The  next 
orator  was  talking  to  a  large  crowd  of  laboring  men 
on  the  evils  of  monopolies  and  our  billionaires  received 
their  full  share  of  condemnation.  The  Salvation  Army 
and  temperance  people  were  also  well  represented  in 
this  complex  of  gratuitous  humane  endeavors.  In  the 
evening  the  great  thoroughfares  presented  a  similar 
spectacle.  Australia  has  more  than  its  share  of  orators 
who  firmly  believe  in  the  power  of  eloquence. 

"Nothing  appears  to  me  nobler  than  to  keep 
assemblies  of  men  entranced  by  the  charms  of 
eloquence.  Avielding  their  minds  at  will,  impelling 
them  at  one  time,  and  at  another  dissuading  them 
from  their  previous  intentions." — Cicero. 

The  orderly  behavior  of  the  people  and  the  close  at- 
tention they  paid  to  the  speakers  is  deserving  of  well- 


AUSTRALIA.  109 

merited  prai?e.  What  Australia  needs  to  develop  its 
shiiiibcrino-  resources  and  to  increase  its  prosperity  is 
a  larger  popidation.  The  present  population  of  this 
great  country  is  less  than  5.000,000,  and  statistics  show- 
that  for  the  last  ten  years  it  has  rather  decreased  than 
increased.  Japanese  and  Chinese  immigrants  are,  by 
a  recent  act,  absolutely  excluded.  For  some  time  these 
yellow  people  paid  $500  for  the  privilege  of  entering 
the  country.  Abject  poverty  and  begging  are  almost 
unknown.  All  classes  of  people  take  a  keen  interest  in 
educational  and  charitable  institutions.  The  typical 
Australian  is  neither  a  European  nor  an  American;  he 
exhibits  qualities  that  indicate  the  geographical  location 
of  his  country  half-way  between  the  European  and 
American  continents,  from  each  of  wdiich  he  has  as- 
similated habits  and  customs  which  characterize  his 
thought  and  action.  He  has  acquired  the  business  tact 
of  the  American  and  retains  the  love  for  recreation  and 
amusement    of   the    Europeans. 

THE    NATIVES. 

The  aborigines  of  Australia  appear  to  be  quite  a  dis- 
tinct race  and  have  nothing  in  common  with  the  South 
Sea  Islanders.  They  bear  a  closer  resemblance  to  the 
Africans  in  the  black  or  dusky  brown  color,  thick  lips, 
short,  flat  noses,  narrow,  high  and  sloping  forehead, 
copious  growth  of  jet  black,  straight  hair.  Men- 
tally they  are  far  beneath  the  Polynesians.  (Eig. 
23.)  They  live  a  nomadic  life,  wn'thout  a  permanent 
habitation,  and  rely  on  fish  and  game  for  sustenance. 
They  were  a  fierce,  warlike  people  who  with  spear,  ar- 
row, clubs  and  boomerang  fought  the  whites  persistently 
until  they  became  convinced  of  the  utter  uselessness 
of  their  efforts  to  resist  the  superior  force  of  the  in- 
vaders. Even  now  the  natives  of  Queensland  in  the 
dense  forests  and  jungles  occasionally  show  a  hostile 
attitude  toward  the  pioneers  in  the  steadily  advancing 
line  of  civilization.     The  natives,  who  numbiered  hun- 


110 


AliOUXU  THE   WOULD  VIA  INDIA. 


dreds  of  thousands  when  the  white  man  took  posses- 
sion of  the  country,  as  the  result  of  a  war  of  extermi- 
nation, and  acute  and  chronic  infectious  diseases  intro- 
duced by  the  whites^  have  been  reduced  to  a  very  small 
numljer.  The  census  taken  in  1902  shows  that  the 
present  native  population  consists  of  52,157  blacks  and 
7,128  half-castes.  The  Tasmanians  fared  even  Avorse 
than  this.  In  1803  the  island  had  at  least  5,000  in- 
habitants. The  whites  began  a  war  of  extermination 
which  lasted   thirty  years.     The   crude   implements   of 


Fi£ 


-Aiislrali.'iii     Mlii>ri,i;ines. 


native  warfare  proved  powerk'ss  against  the  firearms  of 
the  invaders,  and  when  resistance  ceased  there  were  few 
left  to  rebate  the  story  of  tbe  heroic  struggle  made  in 
the  defense  of  their  beloved  island,  and  the  wliites 
could  ease  their  conscience  l)y  asserting: 

"It  is  the  right  of  war  for  eoiKiuerors  to  treat 
those  whom  they  have  ooiKnicred  according  to 
their  pleasure." — Caesar. 

The  race  became  extinct  with  the  death  of  the  last 
Tastnaniau    in    187fi.      Such    is   tb.e   cruel    fate   of   the 


.\isi-i;.\l.i  A.  113 

primitive  race?;.  Tubei'culosi?  and  syi)liilis  are  doing 
their  insidious,  deadly  work  ainong-  the  survivors  of  war 
and  the  ravages  of  aente  infectious  diseases,  and  their 
complete  extermination  is  only  a  question  of  time. 

THE   MIKA   01{    KIIT.PI   OPERATION. 

This  custom  was  first  noticed  by  Eyre  (1845)  in  the 
country  around  the  great  Australian  Bight,  and  is 
well  described  by  Professor  Stuart  of  the  University  of 
Sydney  in  a  paper  read  before  the  Eoyal  Society  of  New 
South  Wales,  June  3,  1896.  The  operation  practically 
consists  in,  generally  at  the  age  of  puberty,  cutting  the 
floor  of  the  urethra  so  that  it  is  slit  completely  open 
from  below,  the  cleft  sometimes  extending  only  half- 
way back,  sometimes  the  whole  way  back  to  the  scro- 
tum. Sometimes  a  mere  perforation  is  made.  The  in- 
tent of  the  operation  is  to  prevent  impregnation,  and 
came  into  use  as  a  safeguard  to  prevent  a  too  rapid  in- 
crease of  the  population,  serving  thus  a  useful  purpose 
in  diminishing  the  struggle  for  existence.  The  opera- 
tion consists  in  creating  a  partial  or  complete  hypo- 
spadias. "The  incision  is  made  with  a  sharp-edged 
piece  of  quartz,  shell,  flint,  or,  in  more  recent  times, 
glass.  These,  fixed  with  resin,  twine,  etc.,  into  handles, 
constitute  the  'mika-knives.'  The  bleeding  is  stanched 
with  sand,  and  the  edges  of  the  wound  are  burnt,  Lem- 
holz  says,  with  hot  stones — perhaps,  as  Etheridge  sug- 
gests, to  cauterize  them — and  keep  from  adhering  again 
and  healing  by  being  kept  apart  with  bits  of  stick, 
wood,  bark  or  bone  inserted  between  them,  or  by  being 
filled  with  clay,  or  by  being  rubbed  with  a  broad-edged 
stone."  The  operation  constitutes  a  kind  of  a  ceremony 
and  is  performed  sometimes  eight  days  after  birth,  but 
more  frequently  between  the  ages  of  14  and  18.  The 
men  thus  operated  on  are  given  privileges  that  are  not 
within  reach  of  the  non-kulpi  men.  In  regard  to  the 
effect  of  this  mutilation  on  the  chances  of  impregna- 
tion opinions  differ.     Eyre,  who  first  described  this  con- 


11-1  AliOlXI)  TlIK   WOULD  VIA   IXDIA. 

dition,  says :  "This  extraordinary  and  inexplicabli"  cus- 
tom must  have  a  i^n'eat  tendency  to  prevent  the  rapid 
increase  of  popuhition,  and  its  adoption  may  perhaps 
be  a  wise  ordination  of  Providence  for  that  purpose, 
in  a  country  of  so  desert  and  arid  a  character  as  that 
which  these  people  occupy."  Professor  Stuart  summar- 
izes his  very  instructive  paper  in  the  following  conclu- 
sions :  1.  ISTothing  whatever  can  be  definitely  stated  as 
to  the  origin  of  the  custom.  2.  The  operation  does  not 
necessarily  render  the  man  sterile.  Tt  merely  dimin- 
ishes his  fertility :  wliat  the  degree  of  diminution  may  be 
will  depend  entiri'ly  on  circumstances. 

THE    SUItVIVING    ABORIGINES. 

A  large  number  of  natives  still  live  in  unexplored 
parts  of  northern  xVustralia  in  their  original  state.  The 
civilized  portion  has  lu'-come  a  government  charge  like 
our  Indians.  They  are  extremely  lazy  and  depend  al- 
most entirely  on  the  g(n'ernment  sn])])ort.  (Fig.  25.) 
I  visited  two  of  these  settlements,  one  at  La  Perouse 
on  Botany  Bay.  seven  miles  from  Sydney,  and  the  other 
at  Coranderrk.  near  Healeville,  .forty  miles  from  Mel- 
bourne. At  each  of  these  places  there  are  about  sixty 
persons,  most  of  them  half-castes.  The  first  colony 
lives  on  a  40-acre  tract  of  land  :  the  latter  has  5.000 
acres  set  aside  l)y  the  government  for  their  exclusive 
use.  At  La  Perouse  they  live  in  small  huts  made  of 
corrugated  iron;  at  Healeville  there  are  small  frame  or 
brick  houses.  Some  of  the  oldest  members  of  these 
settlements  retain  their  original  type  and  wei'e  children 
when  Sydney  and  ^relbourne  were  villages.  All  of  them 
speak  English  and  the  children  have  lost  the  language 
of  their  parents. 

SYDXET. 

Sydney  is  a  prosperous,  growing  city  with  450,000 
inhabitants.  The  houses  are  built  of  stone,  brick  and 
cement  or  [)rick   alone.     Most   of  the  main   thorough- 


^^\  ^  ^ 


Fig-.    2."). — Youns'   native    raotlier    aud    infant. 


AUSTIMLIA.  117 

fares  are  paved  with  hardwood  hlocks.  the  spaces  be- 
tween them  filled  with  cement.  The  electric  light- 
ing and  electric  tram  system,  water  supply  and  sewer- 
age, the  many  public  parks,  library,  museum,  botanical 
and  zoological  gardens  are  the  best  proofs  of  the  wide- 
spread public  spirit  of  its  citizens.  The  university, 
public  and  private  schools,  hospitals  and  other  chari- 
table institutions  and  the  many  churches  speak  well 
for  the  intellectuality  of  its  people.  The  location  of 
the  city  on  the  hills  inclosing  the  magnificent  harbor 
compares  well  with  Naples.  The  country  around  Syd- 
ney surpassed  all  my  expectations.  Dr.  Hinder  gave 
me  an  automobile  ride  of  sixty  miles  and  we  passed 
through  a  country  dotted  with  orange  groves  and  fruit 
orchards,  and  a  part  of  the  faultless  macadamized  road 
led  over  mountains  900  feet  high,  through  virgin  for- 
ests skirting  dark,  deep  ravines,  with  inspiring  glimpses 
of  country  scenes  in  the  far  distance.  The  orange  trees 
are  small  and  not  over  six  feet  in  height,  with  dark 
green,  shining  leaves  in  such  strong  and  beautiful  con- 
trast with  the  heavy  burden  of  golden  fruit.  The  for- 
est, or,  as  it  is  here  called,  the  bush,  was  resplendent 
with  flowers  of  all  hues  and  blooming  shrubs. 

HOSPITALS. 

Sydney  has  made  ample  provision  for  its  sick  poor. 
The  public  hospitals  are  supported  hy  donations  and 
annual  subscriptions;  the  latter  are  doubled  by  the  gov- 
ernment, besides  the  government  pa}'s  for  each  charity 
case  $5  per  week.  None  of  these  hospitals  has  private 
rooms,  but  the  patients  who  have  means  pay  what  they 
can  toward  their  support,  the  maximum  charge  being 
$5  per  week.  Medical  and  surgical  service  is  rendered 
gratuitously  by  the  members  of  the  staff.  The  lack 
of  private  rooms  in  all  of  these  institutions  makes  it 
necessary  to  establish  private  hospitals,  a  number  of 
which  are  conducted  by  nurses;  others  are  owned  and 
managed  by  the  surgeons  themselves. 


118  AHOUNl)  THE  WOULD  VIA  INDIA. 

SYDNEY   HOSPITAL. 

The  Sydney  Hospital  Avas  founded  in  1814  and  the 
original  building  remains  as  a  wing  of  the  new  build- 
ing. It  is  a  massive  three-story  stone  building,  adjoin- 
ing the  House  of  Parliament.  It  is  the  largest  of  the 
hospitals,  the  number  of  beds  aggregating  460.  Two 
large  marble  tablets  in  the  main  hall  are  inscribed  with 
the  names  of  its  donors  in  gilt  letters.  The  smallest 
amount  that  entitles  a  person  to  this  distinction  is 
$850;  the  largest  contribution  among  the  more  than 
100  names  I  noticed  was  $11,500.  The  ceilings  are 
high  and  the  wards  well  lighted  and  ventilated.  Scru- 
pulous cleanliness  prevails  throughout.  There  are  two 
operating  rooms,  one  for  aseptic,  the  other  for  septic 
cases,  and  both  are  well  equipped  for  modern  work. 
Ether  is  the  favorite  anesthetic  and  biniodid  of  mer- 
cury, 1  to  500,  is  used  for  hand  disinfection,  and  cat- 
gut lias  the  preference  over  kangaroo  tendon  as  a  su- 
turing and  ligature  material.  In  the  surgical  wards  I 
found  many  cases  of  fracture  and  excision  of  joints. 
Plaster  of  Paris  is  used  extensively  as  a  fixation  ma- 
terial, both  in  the  treatment  of  fractures  and  after  re- 
section of  joints.  Hip-joint  resections  are  usually  made 
through  the  anterior  Luecke  incision.  Asepsis  is  car- 
ried out  in  a  thorough  manner,  as  was  evident  from 
the  many  primary  wound  healings  I  saw.  The  medical 
staff  is  assisted  by  ten  internes,  graduates  of  the  Syd- 
ney University.  The  appointment  of  internes  is  made 
on  the  merit  of  their  standing  in  their  college  work. 
Those  who  have  the  best  record  go  to  the  Prince  Alfred 
Hospital ;  the  Sydney  Hospital  has  the  next  choice, 
then  come  the  remaining  hospitals.  The  internes  re- 
ceive a  small  salary,  serve  for  one  year  and  receive  the 
benefit  of  all  departments  by  transfer  every  three 
months.  The  Sydney  Hospital  has  an  excellent  train- 
ing school  for  female  nurses,  which  occupies  a  separate 
wing,  the   Nightingale  wing.     The  course   of  training 


L^" 


-^ 


AUSTKAIJA. 


1-il 


extends  over  roui-  years.  The  nurses  ai'e  in  eliarfje  of 
a  matron  and  tlvo  I'rotestant  sisters.  They  receive  a 
small  compensation  during  their  pupilage.  A  well- 
equipped  lahoratory  and  a  complete  Eoentgen  outfit  add 
much  to  the  scientific  work  of  the  institution.  Tin* 
attending  surgeons  are  called  "honorary  surgeons."  Th.' 
present  surgical  staff  consists  of  W.  Chisholm.  ^1.1). 
T.ondon.  ]\r.E.C.,S.  England;  E.  Steer  Bowker.  L.E.C.P. 
Kdin..  :\r.E.C.S.  England;  Thomas  Fiaschi.  M.D.  and 
M.Ch.  Fniv.  of  Pisa:  H.  L.  Maitland,  M.B.,  Ch.M. 
Svdnev.      The   medical    staflF   has   an   ecaial    nuiuhi'i-   of 


Fig.    2S. — A'iew    <ir     Sydney     Hospital    from     the    Northwest. 


members.  The  specialists  are  well  represented  in  this 
institution.  A  very  interesting  feature  in  this  hospital 
is  the  meeting  of  all  attending  men  for  consultation 
every  Tuesday  evening.  At  these  meetings  cases  are 
presented  and  difficult  diagnoses  settled,  and  advice 
freely  given  as  to  the  best  treatment  to  be  pursued. 
This  phase  of  the  medical  service  has  much  to  recom- 
mend for  imitation  in  our  great  hospitals.  Dr.  Fiasc-hi, 
who  conducted  me  through  the  hospital,  showed  mo 
many  cases  of  gastric  and  intestinal  surgery,  all  doing 
well,  and  a  number  of  cases  of  hydatids  recently  oper- 
ated on.     Operations  for  stone  in  kidney  and  bladder 


122 


AROUND  THE  WOKLD  VIA  INDIA. 


and  removal  of  hypertrophied  prostate  are  of  very  fre- 
quent occurrence.  Dr.  Fiaschi  is  in  favor  of  the  su- 
prapubic route  in  both  of  these  operations,  while  some 
other  surgeons  prefer  the  perineal  in  performing  pros- 
tatectomy. I  was  somewhat  surprised  to  learn  that  the 
ligature  remains  popular  in  operations  for  hemorrhoids. 
The  annual  report  shows  that  19  cases  of  hydatids  were 
operated  on,  with  no  death.  Of  these  cases  13  in- 
volved the  liver  and  the  remaining  other  parts.  Of  8 
cases  of  prostatectomy  5  were  cured,  1  relieved  and  2 
died.  No  mortality  in  20  ovariotomies  and  only  1 
death  in  12  cases  of  operation  for  myofibroma. 


Fig.    20. — The    operating    theater,     Sydney    Hospital. 
KOYAL  PRINCE  ALFRED  HOSPITAL. 

This  is  a  modern  hospital  in  every  sense  and  has  ac- 
commodations for  250  patients.  It  is  a  solid  red  brick 
building  three  stories  high,  built  on  the  pavilion  plan. 
It  is  in  this  hospital  that  the  students  of  the  Sydney 
University  receive  their  clinical  teaching  and  training. 
It  was  founded  in  1871  in  memory  of  the  Duke  of 
Edinburgh,  who  visited  Australia  in  that  year  and  was 
wounded  by  a  crank,  who  shot  him.  It  was  framed 
as  a  general  hospital  and  medical  school  for  the  in- 
struction of  students  attending  the  Sydney  University, 


AUSTKALIA.  123 

and  for  training  of  nurses  for  the  sick.  It  is  managed 
by  a  board  of  fifteen  directors.  The  chancellor  of  the 
"university  and  the  dean  of  the  faculty  of  medicine  are 
directors  ex-officio;  three  directors  are  appointed  by  the 
government  and  the  remaining  ten  are  selected  by  the 
government  and  subscribers.  The  medical  officers  are 
all  appointed  by  a  conjoint  board,  consisting  of  the 
senate  of  the  university  and  the  directors  of  the  hos- 
pital. The  selection  is  made  from  the  teachers  of  the 
medical  school  and  the  appointment  is  made  for  six 
years.  The  medical  staff  is  composed  of  three  physi- 
cians, three  surgeons,  two  gynecologists,  one  ophthal- 
mologist, one  dermatologist,  one  rhinologist  and  aurist. 
A  resident  medical  superintendent  and  six  internes  re- 
side in  the  hospital.  The  clinical  amphitheaters  are 
small,  furnished  with  wooden  benches  and  desks,  the 
latter  a  great  convenience  for  the  students  in  recording 
their  observations.  The  training  school  for  this  hospi- 
tal has  seventy  pupil  nurses,  who  remain  for  four  years, 
but  receive  a  small  salary  after  their  period  of  appro- 
bation. 

I  found  in  this  hospital,  under  the  guidance  of  Dr. 
Alexander  MacCormick,  professor  of  surgery  in  the  Syd- 
ney University,  many  rare  and  interesting  cases  of  gas- 
trointestinal surgery.  Professor  MacCormick  has  a 
very  large  service  in  this  institution.  The  remaining 
members  of  the  surgical  stafE  are  Messrs.  Charles  P.  B. 
Clubbe  and  H.  V.  C.  Hinder,  both  of  them  eminent 
and  successful  surgeons.  The  gynecologic  practice  is 
in  the  hands  of  Messrs.  Foreman  and  Thring,  wnose 
reputation  extends  far  beyond  the  limits  of  Australia. 
The  last  annual  report  of  this  hospital  shows  some  very 
remarkable  statistics.  Of  20  cases  of  hydatid  of  the  liver 
operated  on  all  recovered.  In  30  cases  of  cholecyst- 
otomy  operated  on  26  recovered  and  4  died.  No  death 
in  64  radical  operations  for  hernia.  In  16  cases  of  su- 
prapubic and  perineal  cystotomy  2  died  and  14  recov- 
ered.    Sixty-five  cases  of  simple  appendectomy  without 


124  AROUXD    THE    WORLD   VIA    INDIA. 

a  deat.li;  27  cases  of  appendicitis  with  abscass  forma- 
tion with  1  death  ;  14  cases  of  appendicitis  with  rupture 
and  peritonitis,  7  deaths  and  7  recoveries.  Three  cases 
of  pylorectoniy  without  a  death ;  33  abdominal  hysterec- 
tomies with  3  deaths ;  60  cases  of  salpingo-oophorec- 
tomy  for  tubal  disease  with  2  deaths;  11  tubal  gesta- 
tions with  no  mortality.  The  operative  records  of  this 
hospital  make  an  excellent  showing  and  would  compare 
weir  with  those  of  any  hospital  in  America  and  Europe. 
The  outdoor  department  is  in  a  separate  building  and 
furnishes  an  enormous  amount  of  material  for  the  teach- 
ing of  minor  and  casualty  surgery. 

MEDICAL  PROFESSION. 

The  medical  profession  of  Sydney  is  fully  imbued 
with  the  spirit  of  modern  medicine  and  surgery.  Iso- 
lated as  Australia  is  from  the  other  continents,  its  medi- 
cal profession  keeps  pace  with  the  newest  and  best  in 
medicine  and  surgery.  The  country  has  no  lack  of  the 
very  l)est  medical  talent.  The  three  medical  schools 
furnish  an  abundant  supply  of  young,  enthusiastic  and 
well-educated  doctors  to  fill  the  gaps  made  by  death, 
retirement  and  removal,  and  for  this  reason  the  country 
has  no  need  of  medical  men  from  without.  The  doc- 
tor's social  standing  in  Australia  is  much  superior  to 
our  own.  His  financial  possibilities  compare  well  with 
that  of  any  other  country.  A  fair  average  fee  for  a  cap- 
ital operation  is  $250;  maximum,  $500;  consultation 
from  $10  to  $25,  and  visits  average  $2.50.  obstetric  fee 
from  $10  to  $25.  There  are  several  men  in  Sydney 
whose  annual  income  amounts  to  $30,000.  The  coun- 
try practitioners,  of  course,  do  not  fare  so  well,  but 
their  expenses  are  so  much  less  that  at  the  end  of  the 
year  their  bank  account  makes  a  fair  showing.  The 
relations  between  the  members  of  the  medical  profession 
are  cordial  and  the  commercial  element  is  not  nearly  as 
rampant  as  with  ns.  The  requirements  for  entrance 
into  the  practice  of  medicine  are  not  at  all  stringent.    A 


AUSTh'AIJA.  125 

licensing  Ixiard  c.xaiiiiiii's  the  credentials  of  the  a])j)licant 
and,  if  the  candidate  is  in  possession  of  a  diploma  from 
a  recognized  medical  school,  he  is  admitted  withont  pass- 
ing an  examination.  The  local  branch  of  the  British 
Medical  Association  meets  monthly  and  the  sessions  are 
nsnally  well  attended.  The  Anstralasian  Medical  Con- 
gress meets  every  three  years  and  includes  Xew  Zealand. 
Adelaide,  Australia,  August  11,  1904. 

THE  MELBOURNE   HOSPITALS. 

Man,  the  masterpiece  of  creation,  the  image  of  God, 

is  subject  to  pain,  disease  and  death  wherever  chance  or 

circumstance  may  have  fixed  his  abode  in  the  world,  a.s 

"There  is   no  mortal  whom   pain   and   disease   does 
not  reach." — Cicero. 

Primitive  man  has  no,  or  at  best  only  an  imperfect, 
conception  of  the  ways  and  means  to  protect  himself 
against  the  disease-producing  influences  and  he  is  power- 
less, or  nearly  so,  when  afflicted  by  accident  or  disease. 
For  ages  civilized  man  has  endeavored  to  ascertain  the 
cause  of  diseases  and  to  discover  remedies  for  their  pre- 
vention and  successful  treatment.  In  their  primitive 
state  the  aborigines,  living  a  natural  life,  are  less  ex- 
posed to  injury  and  disease  than  civilized  man  living  in 
luxury  and  intent  on  the  accumulation  of  wealth  or  the 
gain  of  fame,  for 

"Increased   means    and    increased   luxuries    are    the 
two  civilizers  of  man." — Disraeli. 

Civilization  and  the  conditions  and  circumstances  at- 
tending and  following  it  have  bred  the  most  destructive 
diseases  unknown  to  the  primitive  races.  Firearms, 
commerce,  increase  of  travel  and  the  various  industries 
incident  to  civilization  are  productive  of  accidents  from 
which  the  natives  in  their  original  state  were  almost 
exempt.  On  the  other  hand,  civilization  has  always 
been  concerned  in  establishing  effective  sanitary  meas- 
ures and  in  devising  rational  and  more  successful  treat- 
ment of  injuries  and  disease.  The  principal  functions 
of  every  intelligent  and  humane  government  consist  in 


136  AROUND  THE  WORLD  VIA  INDIA. 

protecting  its  citizens,  so  far  as  possible,  against  disease 
and  in  making  ample  provisions  for  its  indigent  sick. 
Australia  has  met  these  two  duties  in  a  most  creditable 
manner,  as  is  so  well  shown  by  its  well-organized  effec- 
tive Boards  of  Health,  the  many  excellent  hospitals  and 
other  nnmerons  charitable  institutions.  The  public  hos- 
pitals are  managed  and  supported  nearly  in  the  same 
manner  as  the  hospitals  in  England.  It  is  an  inflexible 
rule  that  none  of  these  hospitals  should  provide  for  pri- 
vate patients.  They  are  supported  by  donations,  life 
and  annual  subscribers,  by  government  appropriations 
and  pay  patients.  The  medical  men  give  their  serv- 
ices gratuitously;  the  internes  and  nurses  receive  small 
salaries.  The  churches  of  different  denominations,  so- 
cieties and  individuals  in  all  the  states  contribute  liber- 
ally toward  the  building  and  maintenance  of  hospitals. 
Protestant  denominational  hospitals  are  unknown. 

Melbourne  is  the  capital  of  the  state  of  Victoria.  It 
is  a  beautiful  city,  built  on  the  undulating  hills  on  both 
sides  of  Yarra  river,  with  a  population  of  nearly  half  a 
million.  Its  streets  are  well  paved,  clean  and  well 
lighted  with  electricity,  and  its  system  of  cable  trams 
affords  an  easy  and  rapid  means  of  reaching  all  parts  of 
the  city  and  almost  every  public  institution.  The  many 
well-kept  public  parks,  botanical  and  zoological  gardens, 
museum  and  library  furnish  ample  proof  of  the  public 
spirit  of  its  citizens.  Xearly  all  of  the  business  build- 
ings and  residences  are  either  solid  stone  or  brick  struc- 
tures. There  is  no  private  residence  without  its  garden 
ornamented  with  subtropical  trees,  flowering  shrubs  and 
flowers.  The  Australian  takes  as  much  pride  in  his 
garden  as  he  does  in  his  house,  and  this  applies  equally 
to  rich  and  poor,  large  residences  and  small  houses. 
The  city  in  its  general  aspects  bears  a  close  resemblance 
to  Belfast,  Ireland.  The  water  supply  and  sewerage 
are  now  in  a  satisfactory  condition  and  have  contributed 
much    in   reducing   the   former   frequency   of   typhoid. 


AL8TKALIA.  127 

THE  MELBOURNE  HOSPITAL. 

The  Melbourne  Hospital  is  tlie  pi-iiieipal  .li-eiicral  hos- 
pital of  the  state.  It  is  centrally  located.  It  is  a  two- 
story  sandstone  building  with  a  wide  front  and  several 
pavilions,  enclosing  a  square  in  the  rear  of  the  main 
building.  Viewed  from  without  it  presents  a  somewhat 
stern,  antique  and  very  massive  appearance.  One  of 
these  pavilions  is  devoted  to  diphtheria  cases  and  stands 
isolated  from  the  remaining  buildings.  The  hospital 
can  accommodate  300  patients.  It  is  in  this  hospital 
that  the  medical  students  of  the  University  of  Mel- 
bourne receive  their  clinical  instruction.  It  has  no  gyne- 
cologic staff,  all  gynecologic  cases  being  referred  to  the 
attending  surgeons.  The  more  legitimate  specialties  are 
well  represented.  The  medical  and  surgical  cases  are 
under  the  care  of  four  physicians  and  an  equal  number 
of  surgeons,  whose  services  are  continuous  throughout 
the  year.  The  resident  staff  consists  of  a  medical  super- 
intendent and  eight  internes.  The  latter  are  selected 
from  the  graduates  of  the  university  who  have  the  high- 
est standing;  they  remain  for  one  year  and  serve  in  the 
different  departments  by  being  transferred  every  three 
months.  The  nursing  is  in  charge  of  several  sisters 
and  92  pupil  nurses.  The  operating  amphitheater  is 
small  but  well  lighted  and  on  elevated  seats  guarded  by 
iron  bars  provides  standing  room  for  the  medical  stu- 
dents and  visitors ;  it  contains  all  the  essential  equip- 
ments for  surgical  asepsis  and  necessary  instruments. 
I  visited  the  hospital  under  the  guidance  of  Mr.  Fred 
D.  Bird,  one  of  the  attending  surgeons  and  professor 
of  surgery  in  the  university.  He  show^ed  me  many 
cases  of  great  surgical  interest,  among  them  several 
cases  of  intestinal  and  gastric  surgery  and  the  usual 
number  of  appendix  operations.  I  was  shown  a  case 
in  which  Mr.  Bird  had  excised  a  perforated  gastric 
ulcer  of  the  small  curvature  of  the  stomach,  four  years 
ago.  near  the  pylorus,  in  a  young  woman.     The  patient 


128  AKOUXD    THE    WOULD    VIA    INDIA. 

made  a  satisfactory  recovery,  but  returned  recently  to 
receive  treatment  for  obscure  digestive  symptoms.  In 
another  case,  a  fourth  operation  for  echinococcus  of  the 
omentum  in  a  young  woman  had  been  successful  a  few 
days  ago. 

In  all  aseptic  cases  the  wounds  had  healed  or  were 
healing  by  primary  intention.  All  the  wards  were  made 
comfortable  and  cheerful  by  fires  in  open  grates  and  a 
liberal  supply  of  flowers  placed  on  the  center  tables  and 
small  bouquets  for  each  bed,  gifts  of  the  Elower  Mis- 
sion. Cyanid  gauze  for  dressing  retains  its  reputation 
in  this  institution.  Fine  silk  has  almost  entirely  dis- 
placed the  absorbable  suture  in  the  practice  of  Messrs. 
Bird  and  Syme.  In  the  absence  of  contraindications 
chloroform  is  used  as  the  routine  anesthetic,  adminis- 
tered with  an  Esmarch  mask.  The  great  work  this 
hospital  is  doing  for  the  sick  of  Melbourne  and  the  state 
of  Victoria  can  be  seen  from  the  last  report,  1903-1904. 
The  total  number  of  patients  treated  was  22,925,  and 
of  these  4,328  were  received  into  the  wards.  The  num- 
ber of  casualties  treated  in  the  out-patients'  department 
was  7,544.  In  the  infectious  diseases  department  338 
cases  were  treated,  of  which  1G2  were  diphtheria.  Al- 
though the  antitoxin  treatment  is  in  constant  use.  intu- 
bation was  performed  on  39  and  tracheotomy  on  14, 
for  the  relief  of  urgent  symptoms,  and  only  two  of  the 
tracheotomies  succeeded  in  saving  life.  This  unfavor- 
able experience  in  the  treatment  of  this  disease  was  due 
to  the  fact  that  many  of  the  children,  when  admitted, 
were  in  a  condition  beyond  the  curative  power  of  the 
specific  treatment.  One  hundred  and  seventy-one  cases 
of  typhoid  fever  Avere  treated  during  the  year,  with  a 
mortality  of  18.  Pneumonia  appears  to  have  been  very 
virulent,  as  G3  out  of  133  ca.'^es  died,  a  mortality  of  near- 
ly 50  per  cent.  The  surgical  showing  of  this  hospital 
is  excellent.  Exploratory  laparotomy  was  made  39 
times  without  a  death.  Of  32  cases  of  hydatids  of  the 
liver  operated  on.  4  died  ;  of  11  cases  of  abdominal  hyda- 


AUSTRALIA.  139 

tids,  all  recovered;  ol'  V)  elioleeystotoiiiies  one  (lie<l ;  of 
103  cases  of  appendicitis  subjected  to  operative  treatment 
15  died,  and  in  40  cases  the  disease  was  complicated  by 
suppuration.  Ovariotomy  was  performed  19  times  with- 
out mortality.  Of  10  cases  of  hysterectomy  3  died ;  11 
cases  of  tubal  pregnancy  with  one  death;  11  operations 
for  pyosalpinx  without  a  death  ;  U!)  operations  for  malig- 
nant tumors,  79  were  relieved,  14  not  benefited  and  6 
died;  in  100  cases  of  radical  operation  for  hernia,  of 
which  number  77  were  inguinal,  3  died.  Of  7  cases  of 
prostatectomy  5  were  relieved  and  3  died.  Two  cases 
of  perforated  typhoid  ulcer  operated  on  died,  and  of  7 
cases  of  perforated  gastric  ulcer  operated  on  only  one 
recovered.  This  hospital,  the  oldest  and  largest  in  the 
city,  is  always  overcrowded  and  lacks  many  features  of  a 
modern  institution,  all  of  which  should  appeal  strongly 
to  the  charitably  disposed  citizens  and  an  appreciative 
generous  government  to  provide  it  with  ample  means 
to  carry  out  its  humane  intentions  on  a  larger  and  more 
efficient  scale  in  the  future. 

lUDICAL  CURE  FOR  INGUINAL  HERNIA. 

Australian  surgeons,  as  a  rule,  prefer  Bassini's  meth- 
od in  operating  for  the  radical  cure  of  inguinal  hernia. 
Professor  Bird  is  in  favor  of  a  small  incision  parallel 
with  and  at  least  one  inch  above  Poupart's  ligament.  He 
is  careful  not  to  injure  the  iibrous  expansion  of  the  su- 
perficial fascia  and  external  oblique  any  more  than  is 
absolutely  necessary  to  reach  the  hernial  sac.  Instead  of 
using  the  knife  freely,  as  is  usually  done,  he  makes  lib- 
eral use  of  blunt  dissection,  thus  separating  instead  of 
cutting  resisting  fibers.  He  never  divides  the  external 
ring  and  insists  that  if  we  divide  it,  no  suture,  however 
deft,  will  make  it  nearly  as  strong  as  before ;  "we  divide 
fibers  whose  integrity  we  can  never  replace."  He  incises 
the  external  ring  only  in  young  subjects  to  procure  room 
to  carry  out  the  necessary  manipulations  in  the  canal. 
He  believes  that  the  unnecessary  divi'^ion  of  the  strong 


130  AROUND  THE  WORLD  VIA  INDIA. 

fibers  of  the  external  ring  is  responsible  for  many  re- 
lapses. He  is  likewise  cautions  not  to  divide  any  of  the 
muscular  fibers  of  the  internal  oblique  and  cremasteric 
muscles,  insisting  that  the  integrity  of  all  these  struc- 
tures should  be  respected.  The  infundibuliform  fascia 
is  torn  through  with  a  pair  of  dissecting  forceps,  and 
the  sac,  carefully  isolated  and  separated  from  the  cord, 
is  then  proceeded  with,  the  isolation  being  commenced 
from  above  and  behind.  The  sac  must  be  cleared  as  far 
up  as  the  deep  epigastric  artery.  The  sac  is  then  tied 
with  catgut  at  the  point  where  it  is  continuous  with  the 
parietal  peritoneum  and  excised  below  the  ligature.  He 
is  of  the  opinion  that  when  the  operation  is  performed 
in  this  manner  deep  Bassini  sutures  are  not  only  un- 
necessary, but  actually  harmful.  Suturing  of  the  in- 
guinal canal  after  excision  of  the  sac  be  only  resorts  to 
when  the  hernia  is  old  and  large  and  when  the  obliquity 
of  the  inguinal  canal  is  much  impaired.  The  sugges- 
tions made  b}"  Professor  Bird  are  based  on  anatomic 
facts  and  should  receive  the  earnest  attention  of  sur- 
geons. 

PROSTATECTO:My. 

This  operation  has  found  much  favor  in  Australia. 
The  suprapubic  and  perineal  route  have  each  their  advo- 
cates. Mr.  G.  A.  Syme,  lecturer  on  anatomy  in  Mel- 
bourne University  and  one  of  the  surgeons  to  the  Mel- 
bourne Hospital,  performed  his  first  prostatectomy  in 
September,  1897.  He  resorted  to  Freyer's  method — 
suprapubic  intravesical  enucleation  of  the  gland.  Two 
vesical  calculi  were  removed  at  the  same  time  and  the 
patient  made  a  speedy  and  perfect  recovery.  In  the 
next  case  he  found  enucleation  impossible  and  he  had 
to  excise  the  projecting  middle  lobe  with  scissors. 
In  his  fourth  case  the  enucleated  mass  weighed 
seven  ounces  and  had  to  be  fragmented  to  per- 
mit its  removal  through  the  vesical  wound.  In 
the   fourth   case   previously    operated   on    for    enlarged 


AUSTRALIA.  131 

prostate,  he  removed  through  the  suprapublic  route  four 
phosphatic  calculi  and  excised  the  projecting  middle 
lobe.  A  third  operation  became  necessary,  and  at  this 
time  anotlior*  stone  was  removed  and  the  entire  gland 
enucleated.  All  these  patients  recovered  with  satisfac- 
tory functional  results.  He  is  a  strong  believer  in  the 
superiority  of  the  suprapubic  over  the  perineal  route 
and  quotes  statistics  from  Melbourne  Hospital  to  sub- 
stantiate the  correctness  of  his  position.  He  advises 
operation  in  all  cases  in  which  the  obstruction  is  caused 
by  the  adenomatous  form  of  prostatic  enlargement. 

ALFRED  HOSPITAL. 

This  hospital,  somewhat  remote  from  the  center  of 
the  city,  has  a  beautiful  location  and  occupies  the  mid- 
dle of  ample  grounds  made  attractive  by  trees,  shrubs 
and  flowers.  It  was  founded  in  1874  and  consists  of 
two-story  brick  pavilions  arranged  around  an  open 
court.  The  wards  are  large,  airy  and  well  lighted  and 
ventilated.  The  main  operating  room  answers  all  mod- 
ern requirements  and  has  a  small  amphitheater  for  stu- 
dents, who  receive  here  the  benefit  of  extra  mural  clin- 
ical teaching.  Three  physicians  and  three  surgeons  con- 
stitute the  attending  staff.  The  consulting  staff  is  made 
up  of  one  physician  and  one  surgeon.  The  surgeons  at- 
tend to  all  g}rQecologic  cases. 

The  surgeons  on  duty  at  the  present  time  are  H. 
O'Hara,  Esq..  F.E.C.S.,"  I.  M.,  and  L.K.Q.O.  P.  I.; 
John  Cook.  Esq.,  M.E.C.S.  Eng. ;  E.  H.  Eussell,  Esq., 
F.E.C.S.  Eng.  As  in  all  Australian  hospitals,  the  out- 
door department  has  separate  attending  staffs  and  anes- 
thetists, electrician,  dentist,  masseurs,  masseuses,  dis- 
penser and  pathologist,  complete  the  list  of  regular  hos- 
pital attendants.  Three  resident  internes  are  appointed 
for  two  and  a  half  years  from  the  graduating  class  of 
the  University  of  Melbourne,  their  merits  being  gauged 
by  their  class  standing.  The  junior  internes  are  paid 
$250  a  year,  the  senior  internes  $500.     The  children's 


133  AKOrXD    THE    WORLD    VIA    INDIA. 

ward  in  this  liospital  i?  one  of  the  finest  I  have  ever 
seen.  The  upper  part  of  the  walls  are  frescoed,  the  pic- 
tures representing  fairy  tales,  and  at  the  foot  of  each 
bed  is  suspended  from  an  erect  curved  wire  a  small 
conical  tin  cup  which  visiting  relatives,  friends  and  the 
Flower  Mission  supply  regularly  with  fresh  cut  flowers. 
I  was  shown  here  a  number  of  cases  of  liver  hydatids 
recently  operated  on.  It  is  the  experience  of  surgeons 
that  these  cysts  seldom  rupture  into  the  stomach  and 
that,  as  a  rule,  they  do  not  give  rise  to  adhesions.  Hyda- 
tid of  the  kidney  is  very  rare.  This  hospital  has  an 
enviable  record  in  the  surgical  treatment  of  perforating 
typhoid  iilcer.  During  the  last  two  years  six  cases  were 
operated  on  and  of  these  only  one  died.  In  about  half 
of  the  cases  this  accident  is  initiated  by  a  sudden  fall 
of  temperature.  Chloroform  is  the  anesthetic  of  choice. 
Silk,  kangaroo  tendon,  catgut,  silkworm-gut  and  horse- 
hair are  all  in  use,  according  to  the  indications  pre- 
sented by  the  wound  under  treatment.  The  govern- 
ment appropriation  for  this  hospital  amounts  to  from 
$15,000  to  $25,000  a  year  and  the  subscriptions  from 
$10  to  $45,000.  Patients  who  can  pay  are  charged  from 
50  cents  to  $7.50  per  week,  the  latter  figure  being  the 
maximum.  This  is  one  of  the  few  hospitals  in  Australia 
supplied  with  a  steam-heating  apparatus.  The  train- 
ing school  for  fenuile  nurses  connected  with  this  hos- 
pital has  50  pu])ils  who  serve  for  three  years  and  have 
to  pass  two  satisfactory  and  quite  rigid  examinations 
before  they  receive  their  certificate.  In  this  connection 
it  is  Avorthy  of  notice  that  in  each  hospital  the  nurse's 
garb  dilfers  in  color,  all  shades  of  blue,  and  gray  and 
black,  with  white  caps  of  the  strangest  designs,  distin- 
guish the  nursing  staffs  of  the  different  hospitals. 

During  the  last  year  1.910  patients  were  admitted  to 
the  wards  and  4,750  out-patients  with  2,058  casualties 
were  cared  for  in  the  outdoor  department.  It  is  note- 
worthy in  looking  up  the  records  of  the  hospital  in  ref- 
erence to  the  religious  convictions  of  the  patients  that 


AUSTIiAl>I.\.  133 

out  of  2,077  eases  only  one  (•0Mffss(v|  that  lie  had  no 
religion,  and  only  one  plaeed  his  confidenee  in  Con- 
fucius. Out  of  iJiJi  eases  of  typhoid  fever  treated  in 
the  hospital  during  the  last  year  11  died,  and  of  90 
cases  of  pneumonia  (i  proved  fatal.  Aneurism  appears 
to  be  much  more  common  than  in  our  country,  as  this 
hospital  received  8  cases  during  one  year.  Abdominal 
hysterectomy  has  a  doleful  record  in  this  hospital,  as  in 
10  cases  only  2  were  discharged  cured,  1  relieved,  3 
remained  in  the  hospital  and  4  died. 

:\[ELliOURNE    HOSPITAL    FOR    SICK    ClIILDHEiV. 

The  ]\Ielbourne  Children's  Hospital  is  an  institution 
that  reflects  much  credit  on  the  state  of  Victoria  and  the 
city  of  Melbourne.  The  hospital  is  beautifully  located 
and  consists  of  a  number  of  two-story  brick  pavilions. 
The  wards  are  large,  airy  and  flooded  with  an  abundance 
of  light.  Flowers,  palms  and  evergreen  plants  impart 
to  all  of  them  a  cheerful  appearance,  which  is  greatly 
accentuated  by  the  presence  of  tidy,  smiling  nurses.  It 
receives  substantial  government  appropriations  and  is 
well  supported  by  voluntary  contributions  in  the  form 
of  legacies,  donations  and  subscriptions.  It  can  accom- 
modate 100  children.  The  medical  and  surgical  staff  is 
made  up  of  ten  members,  with  Charles  S.  Eyan,  M.B., 
Ch.  Edin.,  M.B.  Melb.,  L.M.  Dublin,  at  the  head.  ]\Ir. 
Ryan  is  also  at  the  head  of  the  medical  department  of 
the  military  forces  of  Victoria  with  the  rank  of  colonel. 
The  hospital  has  two  internes  and  45  nurses,  who  re- 
main in  training  for  three  years.  The  convalescents 
are  sent  to  the  convalescent  home  for  children,  Brighton, 
in  charge  of  sister  Danaher,  a  branch  of  this  institution. 
I  visited  the  hospital  in  company  with  Professor  Bird, 
with  Dr.  W.  H.  Summons,  a  member  of  the  attending 
staff  for  the  outdoor  department,  as  chaperon.  The  op- 
erating room  is  perfect  and  supplied  with  all  modem 
improvements  and  appliances.  We  found  here  Dr. 
Mackay  operating  for  hydatid  of  the  liver  in  a  boy  13 


134  AROUND  THE  WOULD  VIA  INDIA. 

years  old,  Avho  had  been  afflicted  with  this  disease  for 
five  years.  The  cyst,  the  size  of  a  man's  fist,  occupied 
the  under  surface  of  the  liver  in  the  region  of  the  sus- 
pensory ligament.  The  incision  was  made  vertically, 
from  the  border  of  the  costal  arch  downward.  The 
cyst  Avas  incised,  opening  of  cyst  drawn  into  the  ab- 
dominal incision  with  the  index  finger,  contents  emptied 
and  margins  of  cut  sutured  to  the  abdominal  wound, 
after  which  the  lining  membrane  was  grasped  with  a 
broad,  blunt  forceps  and  extracted  with  ease.  Two 
drains  and  a  small  absorbent  aseptic  dressing  finished 
the  operation.  I  was  somewhat  surprised  at  the  extent 
to  which  the  Thomas  splint  is  used  here  in  the  treat- 
ment of  tubercular  coxitis  and  spondylitis,  as  its  useful- 
ness can  not  be  compared  with  the  plaster-of-Paris  fixa- 
tion splint  in  the  former  and  the  Eauchfuss  sling  in 
the  latter.  During  the  last  year  the  hospital  cared  for 
1,302  sick  children  and  the  outdoor  department  had  at- 
tendances amounting  to  the  astonishing  number  of  67,- 
489,  of  which  number  10,930  were  nev\r  cases.  Three 
cases  of  hydatid  of  the  mesentery  were  operated  on.  4 
of  the  liver,  2  of  the  lung  and  1  of  the  brain;  all  recov- 
ered. Of  78  cases  of  rheumatism  12  proved  fatal  from 
complications.  One  out  of  two  cases  of  hemophilia  died. 
Seventeen  cases  of  cleft  palate  were  operated  on  without 
a  death,  also  10  cases  of  congenital  dislocation  of  the 
hip  by  the  bloodless  operation  without  mortality.  In 
27  cases  of  chorea  1  died  of  endocarditis.  Of  33  cases 
of  empyema.  6  died.  Of  146  cases  of  pneumonia,  7 
died,  while  the  disease  proved  fatal  5  times  in  24  cases 
of  broncho-pneumonia,  and  5  times  in  32  cases  of  endo- 
pericarditis  and  endocarditis,  and  no  fatality  in  6  cases 
of  pericarditis.  Twenty-two  cases  of  appendicitis  were 
operated  on,  with  4  deaths,  among  them  one  perfora- 
tion ;  and  6  radical  operations  for  hernia,  with  3  deaths. 
In  11  cases  of  intussusception,  the  operation  failed  to 
save  life  in  6.  Of  2  cases  of  cirrhosis  of  the  liver,  both 
diofl.     Of  50  cases  of  tuberculosis  of  spine  and  larger 


AUSTKAI.TA.  135 

joints,  1  died.     No  mortality  in  43  fractures  of  the 

liiiihs.  and  1  deatli  in  4  fractures  of  the  skull. 

ST.  VINCENTS  HOSPITAL. 

This  is  the  only  denominational  hospital  in  Mel- 
bourne. It  is  conducted  by  the  Sisters  of  Charity,  a  re- 
ligious order,  with  the  mother  house  at  Dublin,  Ireland. 
The  present  hospital  is  a  private  residence  reconstructed 
for  hospital  use.  It  can  accommodate  30  patients.  Two 
surgeons,  Mr.  G.  A.  Syme  and  Dr.  William  Moore,  and 
two  physicians  constitute  the  attending  staff,  to  which 
must  be  added  the  different  specialists,  four  anesthet- 
ists, the  pathologist  and  the  members  of  the  outdoor 
department.  Last  year  the  Sisters  received  a  govern- 
ment appropriation  of  $3,500.  The  Catholic  clergy  are 
the  most  liberal  subscribers.  A  small  training  school 
for  nurses  is  connected  with  the  hospital,  in  charge  of 
the  seven  sisters.  One  interne  answers  for  the  resident 
staff.  An  elegant  four-story  brick  building,  with  all 
modern  improvements,  and  which  will  cost  $150,000, 
and  wliich  will  accommodate  200  patients,  is  now  in 
process  of  construction.  The  new  building  when  com- 
pleted will  be  the  best  hospital  in  Melbourne.  Last  year 
10  cases  of  hydatid  were  operated  on,  all  successful ; 
33  cases  of  appendicitis,  with  2  deaths,  in  8  the  disease 
was  complicated  by  suppuration ;  25  cases  of  radical 
operation  for  hernia,  without  a  death,  and  6  cases  of 
suprapubic  cystotomy,  with  no  mortality.  The  whole 
number  of  operations  during  the  year  amounted  to  498, 
of  which  number  490  were  relieved  and  only  3  died,  a 
mortality  of  1.6  per  cent.,  a  record  which  can  not  be 
surpassed  and  which  does  great  credit  to  the  surgeons 
who  performed  the  operations.  I  can  not  quit  Mel- 
bourne without  giving  a  brief  description  of 

A  TRIP  TO   THE   GIANT   EUCALYPTUS   TREES. 

On  his  arrival  at  Sydney  the  travelers  attention  is 
attracted  at  once  bv  two  of  the  characteristic  trees  of 


13()  AltOl'.VI)    T[IK    ^VORLD    MX    INDIA. 

the  eoiinti'v.  tlio  wild  fig  tree  and  the  eiicalyptus  tree. 
Two  species  of  the  former,  the  Ficii^  ansiralis  and 
the  Ficns  macrophylla,  the  ]\Iorton-Bay  Fig-tree,  both 
of  them  indigenous  through  a  great  part  of  East  Aus- 
tralia, the  grandest  of  Australian  avenue  trees.  They 
resemble  each  other  very  closely  in  appearance;  the 
latter,  however,  is  a  larger  tree  and  has  broader  leaves. 
The  stems  are  short,  the  crowns  broad  and  the  roots 
wide-spreading.  There  is  a  dense  foliage  of  evergreen 
leaves,  which  are  oblong,  with  a  deep  green  shiny  upper 
and  a  pale  green  lower  surface.  The  fruit  is  in  the. 
form  of  a  miniature  fig,  with  very  small  seeds,  the 
favorite  food  of  the  wild  pigeon.  These  trees  are  the 
principal  shade  trees  in  this  and  other  Australian 
cities.  The  eucalyptus  tree  is  the  monarch  of  the  Aus- 
tralian forests.  It  is  found  everywhere,  on  the  coast, 
the  plains,  and  invariably  crowns  every  hill  crest  and 
all  mountain  peaks.  It  is  an  intolerant,  jealous,  selfish, 
anarchistic  tree,  its  greatest  virtue  being  its  uncon- 
querable patriotic  sentiments.  Diversity  of  climate 
and  soil  have  succeeded  in  the  course  of  thousands  of 
years  to  break  up  the  original  family  into  nearly  400 
species.  Baron  von  Mueller  has  described  72.  It  is  a 
strange  tree.  It  never  removes  its  green  turban  of  pale 
green,  long,  narrow,  pointed,  aromatic  leaves,  but  in- 
stead throws  off  its  ragged  garment  of  rough  I:)ark  once 
a  year  in  order  to  exhibit  its  new,  gay,  grayish-white 
juvenile  dress.  I  never  lost  sight  of  this  tree  during 
my  l.OOO-mile  railway  joumoy  through  the  coast  dis- 
tricts of  Australia.  The  air  everywhere  was  perfumed 
with  the  ethereal  aromatic  exhalations  of  this  ubiquitous 
tree.  I  had  heard  much  of  the  immense  forests  of  giant 
eucalyptus  trees  of  Australia,  and  was  extremely  anx- 
ious to  satisfy  my  curiosity  to  see  one  of  them.  This 
desire  was  gratified  Sundav,  August  7.  Accompanied 
by  Pi-ofessor  Bird,  his  son,  and  Prof.  G.  A.  Syme,  we 
left  Melbourne  bv  rail  at  11  a.  m.  and  arrived  at  Heals- 


AlS'l'l.-Al.lA.  137 

ville,  40  miles  distant,  two  hours  later,  [[ealsville  is 
at  the  foot  of  a  rantre  of  mountains  that  rise  to  a  heifrht 
of  from  2,500  to  3,000  feet  above  the  level  of  the  sea. 
The  village  is  the  terminal  point  of  the  railroad.  The 
road  passes  through  a  prosperous  agricultural  and  pas- 
turage plain,  from  which  the  mountain  ranges  can  he 
seen  in  the  distance.  The  eucalyptus  tree  attains  its 
largest  size  in  the  moist,  fertile  ravines  and  sinntnits 
of  the  mountains,  where  the  rainfall  is  most  abundant. 
A  carriage  awaited  us  at  the  depot,  and  we  at  once 
ascended  the  excellent  zigzag  road  which  leads  ovei-  one 
of  the  mountain  passes.  From  the  very  beginning  we 
entered  a  forest  of  eucalyptus,  with  an  almost  impene- 
trable undergrowth  of  shrubs  and  bramble.  Rabbits 
shot  across  the  road  with  the  speed  of  lightning,  and 
the  little  Australian  quail  sought,  slowly  and  thought- 
fully, shelter  in  the  inaccessible  jungle.  Magpies  and 
the  laughing  jackass  (Australian  kingfisher)  watched 
our  progress  and  defied  us  in  a  language  replete  with 
mockery.  It  is  a  great  treat  to  see  a  virgin  forest  of 
eucalyptus  trees.  As  we  ascended  the  steep,  tortuous 
incline  the  trees  became  larger  and  larger,  until  we 
reached  the  highest  elevation,  when  we  were  face  to  face 
with  the  patriarchs  who  were  born  centuries  ago  and 
had  nearly  reached  the  limits  of  their  lives.  Here  were 
trees  250  feet  in  height  and  33  feet  in  circumference. 
These  veterans  had  not  forgotten  their  customary 
habits ;  old  and  decrepit,  they  were  engaged  in  throw^ing 
off  their  old  clothing  that  had  served  them  for  fully 
a  vear.  They  began  the  divestment  of  their  dilapidated 
garment  near  the  top  of  the  evergreen  crown,  from 
where  the  rags  were  hanging  down  in  streamers,  swayed 
to  and  fro  by  the  mountain  breeze,  and  many  of  them 
w^ere  lying  in  disorder  at  the  foot  of  the  rejuvenating 
veteran  monarchs  of  the  forest.  They  were  not  prema- 
ture in  changing  their  clothing.  The  bare  parts  of 
their  bodies  and  limbs  were  already  protected  by  a 
brand  new  coat  and  sleeves  of  a  smooth  silverv-white 


138  AROUND  THE  WORLD  VIA  IXDIA. 

investment.  The  tree  that  lifted  its  head  high  above 
everything  around  it  and  reached  the  greatest  dimen- 
sions was  the  Eucalyptus  amagdalina,  the  giant  gum 
tree.  In  some  localities  this  tree  attains  a  height  of 
over  400  feet  and  a  circumference  of  more  than  60 
feet.  About  the  only  other  tree  that  is  congenial  to 
these  anarchistic  mountaineers  is  the  fern  tree.  The 
pale  green  foliage  and  black,  rough  stem  of  the  latter 
is  in  strong  and  pleasing  contrast  with  the  dark  green 
crowns  and  white,  smooth,  bare  trunks  of  the  former. 
We  found  here  three  species  of  fern  trees,  the  Alsophila 
australis,  with  a  low,  thick  stem  and  a  terminal  scanty 
tuft  of  short  cut  leaves,  the  Diclsonia  antartica  and  the 
Diclsonia  davaUoides,  the  high  fern  trees  with  a  slender 
stem  from  20  to  30  feet  in  height  and  an  immense  um- 
brella at  its  top  made  of  fronds  of  enormous  length. 
The  Dicksonia  in  some  localities  is  known  to  reach  a 
height  of  60  feet.  The  blue  gum  tree  {Eucalyptus 
globulus),  grows  in  abundance  in  Victoria.  It  attains 
exceptionally  a  height  of  300  feet.  It  grows  with  un- 
paralleled rapidity  and  yields  a  tough  wood  admirably 
adapted  for  shipbuilding  and  other  purposes  for  which 
a  durable  and  strong  material  is  required.  Ship- 
builders can  get  keels  of  this  timber  120  feet  long.  It 
is  from  this  tree  that  eucalyptol  and  the  various  euca- 
lyptus preparations  are  most  profitably  obtained.  F. 
H.  Faulding  &  Co.,  Adelaide,  are  the  principal  manu- 
facturers of  the  eucalyptus  preparations  used  as  anti- 
septics in  internal  and  external  medications.  We  found 
in  this  forest  a  great  number  of  one  of  the  most  beau- 
tiful of  the  ornamental  trees  of  Australia — the  golden 
wattle  {Acacia  pycnantha),  opening  its  blossoms  of 
golden  yellow  in  the  form  of  long,  drooping  tassels. 
When  in  full  bloom  the  evergi-een  leaves  are  almost  ob- 
scured by  this  golden  drapery.  The  tree  attains  a  maxi- 
mum height  of  about  30  feet;  its  long,  slender  trunk 
is  branchless  almost  to  its  very  top,  and  when,  with  the 
earliest  indications  of  approaching  spring,  it  decorates 


AUSTRALIA.  139 

itself  with  a  crown  of  gold,  it  presents  a  lovely  sight, 
oven  in  the  shadow  of  the  giants  of  the  eucalyptus  race. 
The  sight  of  a  eucalyptus  forest  intermingled  with  the 
fern  trees  and  the  golden  wattles  and  sprinkled  with 
the  fresh  and  brilliant  early  spring  flowers  is  inspiring 
and  leaves  a  pleasai^t  impression  which  time  can  never 
erase  from  memory. 
Fremantle,  Australia,  August.  15. 

THE   ADELAIDE   HOSPITALS. 

Adelaide  is  the  capital  of  the  state  of  Southern  Aus> 
tralia.  A  railroad  seven  miles  long  connects  it  with  tht 
harbor,  Port  Adelaide.  It  is  the  intellectual  as  well  as 
the  business  center  of  the  state.  The  city  is  located 
in  the  midst  of  an  extensive  fertile  plain,  with  a  range 
of  tree-clad  hills  in  the  distance  and  the  ocean  in  the 
opposite  direction.  Its  streets  are  wide,  well  laid  out, 
well  paved  and  clean,  but  the  electric  lighting  is  con- 
ducted on  an  economic  scale.  Present  population,  60.- 
000.  The  bobtail  horse  trams  remind  one  of  the  size 
of  the  city,  while  the  substantial  sandstone  buildings  in 
its  main  streets  would  do  credit  to  any  of  our  large 
cities.  Australian  cities  have,  fortunately,  no  need  of 
sky  scrapers,  which  disfigure  our  large  cities;  buildings 
more  than  three  stories  high  are  the  exception,  and 
time-saving,  muscle-weakening  and  lung-crippling  ele- 
vators have  as  yet  but  a  limited  sphere  of  questionable 
usefulness.  Adelaide  has  a  young,  prosperous  univer- 
sity, splendid  botanic  and  zoologic  gardens,  public  li- 
brary, art  gallery,  museum  and  a  number  of  attractive 
parks.  It  is  an  ideal  university  city,  where  students  are 
given  all  conceivable  opportunities  to  enrich  their  minds 
with  object  lessons  in  all  the  arts  and  sciences,  and 
where  they  are  free  from  the  many  temptations  which 
lurk  in  such  abundance  in  all  of  the  large  cities.  Medi- 
cal students  are  given  here  very  thorough  didactic 
teaching,  and  the  clinical  material  is  large  enough  for 
practical  instruction  in  medicine,  surgery  and  the  dif- 


140  AUOL'XD  THE   WOULD  VIA  INDIA. 

ferent  specialties.  The  liospitals  of  Adelaide  receive 
patients  from  all  parts  of  the  state  and  furnish  the 
medical  department  of  the  university  with  an  abundance 
of  material,  which  is  utilized  by  the  teachers  to  greatest 
advantage  for  bedside  and  amphitheater  instruction.  It 
is  somewhat  remarkable  that  none,  of  the  general  hos- 
pitals of  Australia  makes  any  provision  for  maternity 
eases,  but  all  medical  schools  have  a  large  out-door  ob- 
stetric department,  where  the  students  receive  practical 
instruction  at  the  bedside  of  the  poor  in  this  most  im- 
portant branch  of  the  healing  art.  One  of  the  rigid  re- 
quirements for  graduation  in  all  of  the  medical  schools 
is  to  the  effect  that  the  candidate  must  present  evi- 
dence that  he  has  attended  a  specified  number  of  con- 
finement cases. 

THE   ADELAIDE    HOSPITAL. 

The  Adelaide  Hospital  is  the  largest  and  only  public 
general  hospital  in  the  city  and  its  medical  affairs  are 
controlled  by  the  clinical  staff  of  the  university.  It  was 
founded  50  3-ears  ago  and  can  accommodate  240  pa- 
tients. The  main  building,  of  sandstone  with  brick  cor- 
ners, is  two  stories  high.  It  is  situated  some  distance 
back  from  the  street  in  the  rear  of  an  open  square  which 
has  been  converted  into  a  beautiful  little  park,  with  well 
laid  out  gravel  drives  and  walks  and  shaded  with  a  va- 
riety of  trees  and  ornamented  with  shrubbery  and 
flowers.  The  remaining  two  inchiding  sides  of  the  park 
are  occupied  l)y  one-story  buildings,  most  of  them  of 
recent  construction.  The  operating  theater  now  in  use 
is  antique  and  the  surgeons  are  anxiously  awaiting  the 
opening  of  the  new  one,  which  is  nearing  completion 
and  Avhich  has  been  well  planned  and  will  represent 
the  most  modern  improvements  in  this,  the  most  im- 
portant part  of  any  hospital.  The  wards  in  the  old 
building  are  somewhat  gloomy  and  not  sufficiently 
lighted.  The  electric  light  has  not  as  j'et  been  intro- 
duced, and  the  scanty  gas  jets  at  night  can  be  no  im- 


AUSTRALIA.  143 

provement  on  the  defective  daylight.  Heat  is  supplied 
by  open  coal  fires.  In  one  of  the  surgical  wards  the 
grates  occupy  the  base  of  a  beautifully  frescoed  square 
column,  which  contributes  much  to  the  cheerfulness  of 
the  otherwise  somber  room.  As  in  all  Australian  hos- 
pitals, a  profusion  of  flowers  imparts  to  the  sick  rooms 
a  liomelike  and  cheerful  appearance.  Owing  to  a  some- 
what miserly  government  aid,  it  is  interesting  to  know 
the  sources  from  which  the  additional  funds  are  ob- 
tained to  carry  on  the  work  of  this  deserving  charity. 
For  the  purpose  of  stimulating  the  spirit  of  charity 
among  the  people  the  contributors  are  given  certain 
])rivileges,  a  practice  which  it  would  be  well  for  some  of 
our  hospitals  to  imitate.  On  this  subject  I  will  quote 
from  the  last  annual  report  of  the  hospital : 

"1.  Every  contributor  of  £3  annually  shall  have  the 
privilege  of  recommending  one  indoor  patient  in  the 
year;  of  £5  annually,  three  indoor  patients  in  the  year; 
of  £10  annually,  the  privilege  of  having  always  one 
patient  in  the  hospital. 

"2.  Contributors  of  £2  annually  shall  also  have  the 
privilege  of  recommending  six  out-door  patients  for  re- 
lief from  the  dispensary;  contributors  of  £5,  twelve 
patients,  contributors  of  £10,  fifteen  patients.  It  is 
to  be  distinctly  understood  that  these  recommendations 
are  only  to  be  issued  by  the  contributors  to  persons 
who  can  not  pay  for  medical  treatment  elsewhere. 

"3.  Life  contributors  to  have  the  same  privilege  in 
proportion.  Their  donations  being  estimated  as  annual 
contributions  of  one-tenth."  The  restriction  placed  on 
the  issuing  of  recommendations  on  these  terms  is  re- 
peated once  more  in  paragraph  5,  regulating  the  ad- 
mission of  patients :  "It  is  to  be  distinctly  understood 
that  these  recommendations  are  only  to  be  given  to 
persons  who.  on  account  of  their  poverty,  are  proper 
subjects  for  hospital  treatment."  In  paragraph  6  pro- 
vision is  made  to  exclude  charity  patients  who  are  able 


l-i-i  AUOUXD  TPIE   WOULD  VIA  IXDIA. 

to  pay  for  medical  service :  "Applicants  for  admission 
to  the  hospital  shall,  unless  possessed  of  means  suffi- 
cient to  pay  for  medical  advice,  make  a  declaration,  on 
a  form  printed  for  that  purpose,  to  the  effect  that  they 
are  imable  to  pay  for  medical  advice,  and  stating 
whether  they  are  entitled  to  medical  attendance  from 
any  benefit  society  or  lodge." 

That  these  declarations  are  not  always  in  accord  with 
facts  became  evident  to  me  in  visiting  the  different 
hospitals.  Many  patients  find  their  way  into  the  hos- 
pitals who  are  abundantly  able  to  pay  the  physicians  a 
fair  remuneration  for  their  services.  The  abuse  of 
charity  is  practiced  here  as  well  as  elsewhere  on  a  large 
scale.  The  people  are  fully  aware  of  the  fact  that  they 
can  secure  the  very  best  medical  and  surgical  talent  in 
hospitals  connected  with  medical  schools,  and  are  will- 
ing to  declare  and  sign  almost  anything  to  avail  them- 
selves of  the  gratuitous  services  of  the  attending  staff'. 
The  Adelaide  Hospital  cares  for  many  such  impostors. 
Adelaide  and  the  surrounding  agricultural  and  pastoral 
country  are  in  a  prosperous  condition,  and  many  who 
seek  the  shelter  of  this  hospital  rob  it  and  tlie  medical 
profession  annually  of  a  large  amount  of  money  which 
they  have  well  earned  and  to  which  they  are  justly  en- 
titled. Such  abuse  of  charity  is  difficult  to  remedy, 
more  especially  in  the  case  of  hospitals  connected  with 
medical    schools. 

Drs.  E.  C.  Stirling  and  Archibald  Watson  are  the 
consulting  ph3'sicians  and  surgeons.  Four  physicians 
constitute  the  medical  and  three  surgeons  the  surgical 
staff.  The  present  surgical  staff  consists  of  Leonard 
W.  Bickle.  M.E.C.S.  Eng.,  L.E.C.P.  London,  F.E.C.S. 
Edin.;  William  Anstey  Giles,  M.B.,  Ch.M.  Edin.;  Ben- 
jamin Poulton.  M.D.  Melb.,  M.E.C.S.  Eng.  Two  gyn- 
ecologists, two  ophthalmologists,  one  surgeon  for  the 
ear  and  tliroat,  a  bacteriologist,  a  dentist  and  two  path- 
ologists complete  the  list  of  medical  officers  with  the 
exception  of  the  resident  medical  superintendent,  Mr. 


AUSTKAl.lA. 


1-15 


F.  J.  ChallVc,  six  assistants  and  live  internes.  Tlie  in- 
ternes ail'  selected  i'rdiii  the  graduating  class  of  the 
university  on  their  college  standing.  One  of  these  in- 
ternes is  a  woman,  who  assists  Mr.  Giles  in  his  sur- 
gical work.  The  women  internes  in  this  hospital  have 
made  an  excellent  record.  The  internes,  as  in  all  Aus- 
tralian hospitals,  receive  a  small  salary  and  serve  for 
one  year.  The  training  school  for  female  nurses  con- 
nected with  the  hospital  has  50  pupils,  several  sisters 
and  a  matron.  The  nurses  remain  in  training  for  three 
years  and  receive  annually  from  $100  to  $200,  accord- 
ing to  the  length  of  time  of  their  service.  The  new 
laboratory  is  capacious,  well  lighted  and  is  in  charge 
of  a  graduate  nurse,  who  does  all  the  mechanical  work 
and  prepares  the  culture  mediums.  Patients  suffering 
from  tuberculosis  of  the  lungs  do  not  remain  in  the 
lK)s])ital  for  any  length  of  time,  as  they  are  sent  from 
here  to  a  sanatorium  in  the  mountains  seven  miles 
from  Adelaide,  built  specially  for  this  purpose  and 
managed  by  the  same  administration.  Other  infective 
diseases  are  not  admitted  to  the  hospital.  Turpentine 
and  biniodid  of  mercury  solution  are  favorite  anti- 
septics with  many  Australian  surgeons  in  hand  disin- 
fection. Catgut  and  kangaroo  tendon  have  been  largely 
displaced  by  fine  silk.  'On  the  whole,  chloroform  is  used 
more  frequently  than  ether  as  an  anesthetic.  Cyanid 
gauze  as  an  inner  dressing  for  wounds  remains  popular. 
I  had  the  pleasure  of  seeing  considerable  of  the  sur- 
gical work  of  two  of  the  clinical  professors  of  surgery  in 
the  imiversity.  Dr.  Poulton  and  Mr.  Giles.  The  former 
I  found  operating  on  a  case  of  prostatic  hypertrophy  in 
a  man  65  years  of  age.  who  had  suffered  from  the  ob- 
struction for  several  years.  The  usual  long  suprapubic 
vertical  incision  was  made,  .  the  peritoneal  reflection 
pushed  upward,  and  the  bladder  incised  on  the  po'nt 
of  a  sound  previously  introduced  into  the  bladder  and 
held  in  position  by  an  assistant.  Eepeated  efforts  to 
enucleate  the  gland  after  incision  of  the  mucosa  failed. 


146  AROUXD    THE    WORLD    VIA    INDIA. 

It  was  one  of  those  cases  in  which  the  enlargement  wa-s 
not  due  to  the  growth  of  adenomata,  but  to  a  hyper- 
troph}^  of  the  gland  itself,  hence  the  impossibility  of 
removing  it  by  intravesical  enucleation.  It  is  in  such 
cases  that  the  most  experienced  surgeon  will  fail  in  re- 
moving the  obstruction  by  the  suprapubic  route.  Su- 
prapubic drainage  of  the  bladder  was  established  by  the 
use  of  rubber  tubing  fixed  in  the  lower  angle  of  the 
wound  with  sutures  and  the  balance  of  the  wound  care- 
fully closed.  The  next  operation  was  performed  by  one 
of  his  assistants.  The  patient  was  a  man  72  years  old, 
the  subject  of  a  tumor  nearly  the  size  of  a  fetal  head 
occupying  the  right  parotid  and  submaxillary  regions. 
There  could  be  no  question  as  to  the  malignant  nature 
of  the  tumor,  as  it  had  reached  its  present  dimensions 
since  last  Christmas.  As  the  labial  branch  of  the  facial 
nerve  had  lost  its  functions  it  was  suspected  that  the 
tumor  had  its  starting  point  in  the  parotid  gland.  The 
operation  was  a  very  difficult  one,  but  was  executed  with 
care  and  precision.  The  operator  from  time  to  time 
availed  himself  of  anatomic  information  furnished  by 
Professor  Watson,  who  stood  by  and  watched  every 
step  with  his  eagle  eyes.  The  lymphatic  glands  were 
not  involved  and  the  operation  demonstrated  that  the 
tumor  had  its  origin  in  the  submaxillary  salivary  gland 
and  was  undoubtedly  a  sarcoma.  One  of  the  most  in- 
teresting cases  in  Dr.  Poulton's  wards  was  a  man  in 
middle  life  who  had  recently  been  operated  on  for  an 
obscure  swelling  in  the  region  of  the  gall  bladder  and 
extending  to  the  right  lumbar  region.  Positive  diag- 
nosis could  not  be  made,  although  it  was  suspected 
that  it  was  connected  either  with  the  gall  bladder  or 
right  kidney.  It  was  first  noticed  a  year  ago.  Ureteral 
catheterization  in  the  male,  as  a  diagnostic  aid.  has  so 
far  not  been  practiced  by  any  of  the  Australian  sur- 
geons so  far  as  I  was  able  to  ascertain.  The  French  sep- 
arator (Luys),  on  the  other  hand,  is  frequently  made 
use  of.    In  this  case  a  vertical  incision  was  made  from 


AUSTRALIA.  147 

the  eighth  costal  cartila<i:o  downward.  On  cutting 
through  the  abdominal  wall  the  retroperitoneal  location 
of  what  now  could  be  recognized  as  a  cyst  wa?  ascer- 
tained without  any  difficulty,  the  ascending  colon  being 
displaced  inward.  Marsupialization  was  resorted  to. 
This  term  is  often  employed  by  Australian  surgeons 
to  indicate  the  radical  operation  for  echinococcus  cysts 
and  the  treatment  of  other  cysts  by  incision  and  drain- 
age. This  word  was  coined  here  and  owes  its  origin 
to  the  many  species  of  marsupial  animals  which  in- 
habit Australia,  animals  which  give  birth  to  their  off- 
spring in  the  embryonic  state  and  mature  them  in  a 
pouch  on  the  ventral  side  of  the  body,  where  the  young 
have  easy- access  to  the  milk-supplying  breasts.  After 
opening  and  stitching  the  sac  to  the  abdomnial  incision, 
the  dermoid  character  of  the  cyst  was  demonstrated  by 
the  escape  of  a  large  quantity  of  hair  and  sebaceous  ma- 
terial. The  patient  was  doing  well,  relieved  of  all  sub- 
jective symptoms,  and  only  a  small  quantity  of  a  mu- 
coid fluid  was  discharged  daily  through  the  drain 
which  remained  in  the  cyst.  Such  cases  in  this  particu- 
lar location  are  extremely  rare,  and  it  is  to  be  hoped 
that  a  full  report  of  the  case  will  soon  find  its  way 
into  the  current  medical  literature.  The  safety  of  the 
operation  was  enhanced  in  this  case  by  previous  firm 
adliesions  between  the  two  layers  of  the  peritoneum,  so 
that  the  marsupialization  was  practically  extraperito- 
neal. It  has  been  observed  in  this,  as  well  as  in  other 
hospitals  of  Australia,  that  the  al)origines  arc  more 
frequently  afflicted  with  hydatids  than  the  whites,  as 
they  are  more  exposed  to  infection,  living  with  numer- 
ous dogs,  and  often  obtaining  their  water  supply  from 
stagnant  pools.  Dr.  Altman,  of  Bright,  has  operated 
on  many  natives  afflicted  with  this  disease.  All  sur- 
geons consider  the  natives  good  subjects  for  narcosis 
and  capital  operations.  They  are.  however,  very  prone 
to  homesickness  and  slinrtcn  their  stav  even  in  the  best 


148  AROUND    THE    WORLD   VIA    INDIA. 

hospitals  as  much  as  their  condition  will  permit.  The 
surgical  wards  of  the  hospital  contain  28  beds,  and  ihe 
new  pavilions  are  perfect  in  construction  and  appli- 
ances. The  upper  part  of  the  Avails  are  artistically 
frescoed,  the  pictures  pleasing  and  well  selected  for  the 
purpose  for  which  they  have  been  intended. 

The  next  day,  July  10,  I  visited  the  hospital  again, 
this  time  with  Mr.  Giles,  dean  of  the  medical  faculty 
and  professor  of  clinical  surgery,  who  had  in  his  wards 
many  very'  instructive  cases.  One  case  was  of  special 
interest  to  me,  and  had  misled  the  surgeon,  and  would 
have  misled  anyone  else,  in  making  a  correct  ante- 
operation  diagnosis.  The  history  of  the  case  pointed 
to  appendicitis.  The  operation  revealed  a  -retrocecal 
subperitoneal  suppurating  hydatid  of  the  right  iliac 
fossa.  The  operation  yielded  the  expected  relief,  sup- 
puration has  almost  ceased,  and  the  patient  wiHsoon 
be  discharged,  restored  to  perfect  health.  Within  a  very 
few  weeks  Mr.  Giles  had  operated  on  three  cases  of  un- 
descended testicle,  complicated  by  hernia.  In  all  the 
results  were  excellent.  Mr.  Giles  has  the  reputation 
of  being  one  of  the  most  conservative  and  successful 
surgeons  of  Southern  Australia,  and  his  clinical  teach- 
ing is  highly  appreciated  by  his  attentive  classes.  Ap- 
pendicitis appears  to  be  unusually  prevalent  in  South- 
ern Australia,  as  I  was  shown  many  cases  recently 
operated  on  in  the  wards  of  both  Dr.  Poulton  and  Mr. 
Giles,  and  I  have  no  reason  to  believe  that  either  of 
these  surgeons  would  resort  to  the  use  of  the  knife 
unless  the  indications  were  clear. 

The  great  prevalence  of  hydatid  in  Adelaide  and  sur- 
rounding country  is  well  shown  by  the  records  of  this 
hospital.  Last  year  34  cases  were  operated  on,  of  which 
number  3  died.  Pneumonia  appears  to  have  been  very 
virulent,  as  of  G9  cases,  43  were  cured,  4  relieved,  and 
22  died.  Of  30  appendicitis  operations,  2G  were  cured 
and  4  died;  2  deaths  in  19  cases  of  ectopic  pregnancy; 


Ars'niAi.iA. 


149 


•^9  causes  of  i)yosali)inx,  with  '21  cures.  1  i-elicvcd,  4  iiii- 
roliovcd,  and  .">  (h'atlis;  1(5  cases  of  iiiyoCibroniata,  12 
cured,  2  unrelieved,  and  3  died;  5  gastro-enterostomies, 
with  2  deaths;  41  radical  operations  for  in<,aiiiial  and 
femoral  hernia,  witliout  mortality:  10  cjises  of  strangu- 
lated hernia,  with  4  deaths;  5  cases  of  lithoti'ity.  with  1 
death;  1  ca^es  of  ])rostatectomy.  with  .'i  cured  and  1  re- 
lieved; 2T  hysterectomies,  21  cured,  1  relieved  and  •"» 
died  ;  20  excisions  of  varicose  veins,  without  mortalitv. 


Fig.    .'!1. —  View    Oil    tlio    urnuu 


Ailclaiclc    Childron's    Ilnsyital. 


ADELAIDE    CPIILDREX  S   HOSPITAL. 


The  foundation  stone  for  this  excellent  institution 
for  the  care  of  sick  children  was  laid  June  20,  1878, 
for  what  is  now  known  as  the  Way  Building,  and  four- 
teen months  later  the  first  patient  was  admitted.  The 
Way  Building  and  a  number  of  one-story  pavilions 
since  erected  enclose  an  open  square  where  the  little 
patients  can  enjoy  the  sunshine  and  outdoor  air  and 
find  ample  room  among  the  shade  trees  for  their  child- 
ish  amusements.     The  hospital    is   located   on   a   high 


150  AROUND    THE    WOULD   VIA    INDIA. 

ridge,  from  where  a  beautiful  view  can  be  obtained  of 
the  city  and  the  distant  mountain  ranges  (Fig.  29). 
It  has  accommodations  for  80  patients.  All  the  build- 
ings are  of  stone,  and  the  wards  are  well  lighted  and 
cheerful.  The  diphtheria  ward  is  never  empty.  One 
of  the  trained  nurses  administers  the  antitoxin  under 
the  direction  of  the  attending  physicians.  The  same 
nurse  also  has  charge  of  the  laboratory.  The  visiting 
medical  officers  are :  W.  M.  Campbell.  L.E.C.P.,  Edin. ; 
Alfred  E.  Wigg,  M.D.;  Brux.;  Alfred  Lendon,  M.D., 
London;  Harry  Swift,  B.A.,  M.D.,  Camb. ;  A.  M. 
Morgan,  M.B.,  B.S.,  Ad.;  E.  Brumritt,  M.E.C.S.  Two 
consulting  medical  officers,  two  consulting  pathologists, 
and  one  oculist,  two  dentists,  one  aurist,  seven  anes- 
thetists, one  pathologist,  one  bacteriologist,  one  radiog- 
rapher, one  sanitary  adviser,  one  registrar  and  one  in- 
■terne  complete  the  long  list  of  medical  men  who  serve 
this  institution.  One  matron  and.  a  staff  of  six  sisters 
$upervise  the  nursing  and  have  charge  of  the  training 
school,  which  has  at  present  an  attendance  of  50  pupil 
nurses.  The  hospital  is  kept  scrupulously  clean,  and 
the  little  patients  receive  the  benefits  of  nursing  of 
the  highest  order  and  the  very  best  medical  and  surgical 
service.  Electric  lighting,  complete  equipments  and 
appliances  for  diagnosis  and  all  kinds  of  surgical  work 
add  much  to  the  efficiency  of  the  institution.  Medical 
students  are  admitted  to  the  clinics,  and  several  mem- 
bers of  the  attending  staff  are  clinical  professors  of  the 
u.niversity.  This  hospital  is  kept  supj)lied  throughout 
the  entire  year  with  a  wealth  of  flowers. 

The  citizens  of  Adelaide  take  great  interest  in 
this  hospital,  and  tbeir  liberal  contributions  enables 
the  administration  to  carry  out  its  humane  inten- 
tions in  the  most  satisfactory  manner,  I  visited  the 
hospital  in  company  with  Dr.  Lendon,  professor  of 
obstetrics  and  diseases  of  children,  who  is  familiar  with 
all  the  details  of  its  construction  and  management,  and 
is  one  of  the  most  influential  members  of  its  medical 


AUSTILVLIA.  151 

staff.  During  the  last  year  704  new  patients  were  ad- 
mitted. One  hundred  and  two  operations  were  per- 
formed on  indoor  patients  and  364  on  out-patients. 
Chloroform  alone  was  used  as  an  anesthetic  .50  times ; 
ether.  58 ;  gas,  4 ;  chloroform,  followed  by  ether,  -353 ; 
gas,  followed  by  ether.  1.  Appendicitis  operation,  only 
1,  and  this  patient  died.  Tuberculosis  of  the  hip  joint 
figures  conspicuously  in  the  list  of  surgical  cases.  Of 
25  cases,  only  2  were  subjected  to  operative  treatment, 
showing  conclusively  the  conservatism  which  is  ob- 
served in  this  hospital  in  the  treatment  of  joint  tuber- 
culosis. Of  78  cases  of  diphtheria,  the  disease  proved 
fatal  in  3.  Fifty  cases  of  typhoid  fever  were  treated 
without  a  death,  certainly  a  remarkable  record,  and  27 
cases  of  pneumonia,  with  only  4  deaths. 

GALLSTONE    IN    ELEPHANTS. 

Dui-ing  the  last  year  three  Indian  elephants  have 
died  in  the  zoologic  gardens  of  Australia,  one  in  Mel- 
bourne, one  in  Queensland,  and  the  last  one  in  Ade- 
laide. When  I  visited  the  museum  of  the  university 
with  Professor  Watson  the  taxidermists  were  engaged 
in  mounting  the  last  victim.  This  elephant  was  of 
enormous  size.  He  had  been  an  inmate  of  the  Adelaide 
zoologic  garden  for  a  long  time,  and  was  30  years  old. 
He  was  sick  only  a  short  time,  and  the  postmortem, 
conducted  by  Professor  Watson,  revealed  as  the  imme- 
diate cause  of  death  an  enormous  abscess  in  the  center 
of  the  liver,  and  in  this  abscess  was  found  a  gallstone 
that  weighed  25  pounds.  As  the  elephant  has  no  gall 
bladder,  this  stone  must  have  formed  in  one  of  the 
hepatic  ducts.  This  rare  and  valuable  specimen  dis- 
appeared in  a  somewhat  mysterious  way  before  it  could 
be  taken  to  the  museum,  and  it  was  ascertained  later 
that  it  was  purchased  from  the  pilferous  possessor  by 
a  Chinaman,  who  paid  $10  for  it  and  considered  it  a 
great  bargain,  as  he  expected  to  realize  a  fortune  from 
it  by  converting  it  into  a  cure-all  medicine  for  his  sick 


152  AROUND  THE  WORLD  VIA  INDIA, 

compatriots.  The  ]\Ielbonrne  elephant  on  postmortem 
was  found  to  have  died  from  the  same  disease,  but  the 
calcnlns  was  mnch  larger,  weighing  more  than  100 
pounds.  It  is  not  definitely  known,  bnt  it  is  surmised 
that  the  Queensland  elephant  met  with  a  similar  fate. 
It  seems  that  all  large  animals  from  tropic  regions, 
when  brought  into  confinement,  are  subject  to  inflam- 
matory affections  of  the  bile  ducts  and  subsequent  gall- 
stone formation.  As  elephants  even  in  Australia  com- 
mand a  price  of  $3,000,  what  inducement  there  w^ould 
have  been  to  perform  on  these  giant  patients  a  life- 
saving  hepatotomy! 

POSTMORTEM   ON   A   ZEBRA. 

One  evening,  in  visiting  the  zoologic  garden  in  Ade- 
laide in  company  with  Professor  Watson  and  the  super- 
intendent of  the  garden,  a  fine-looking,  slick,  well-nour- 
ished zebra  came  up  close  to  the  fence  and  seemed  to 
enjoy  mv  patting  her  forehead  and  well-roiuided  neck. 
The  animal  appeared  to  be  in  perfect  healtli.  It  had 
been  in  the  garden  for  twelve  years  and  was  old  when 
it  was  brought  there.  The  next  morning  I  was  in- 
formed by  Professor  Watson  that  the  animal  had  died 
during  the  night.  In  the  afternoon  I  attended  the 
postmortem,  which  was  made  under  the  direction  of 
Professor  Watson.  The  abdomen  was  enormously  dis- 
tended, which  seemed  to  indicate  that  the  sudden  death 
was  due  either  to  intestinal  perforation  or  acute  intes- 
tinal obstruction.  On  opening  the  abdomen  the  giant 
cecum,  ascending  and  descending  colon  were  found  dis- 
tended to  their  maximum  limits.  Large  isolated  sec- 
tions of  the  liver  were  the  seat  of  great  dilatation  of  the 
bile  ducts,  many  of  them  sacculated,  and  on  slitting 
them  open,  were  seen  to  contain  a  thick,  turbid  mucus, 
the  inflammatory  accumidation  of  a  chronic  cholangitis. 
Numerous  ascarides  lumbricoides  of  prodigious  size 
were  foimd  in  the  stomach,  well  filled  with  the  remains 
of  the  last  evening  meal.    The  upper  part  of  the  lumen 


AUSTRALIA.  l->> 

of  the  small  intestines  was  almost  entirely  occluded  by 
wriggling  masses  of  the  same  parasite,  and  they  were 
also  numerous  tliroughout  the  large  int;estine.  The 
transverse  colon  was  of  normal  size,  cecum,  ascending 
and  descending  colon  impacted  with  dry  fecal  matter 
alive  with  worms.  It  is  evident  tliat  the  immediate 
cause  of  death  was  the  result  of  mechanical  obstruction, 
complicated,  perhaps,  by  toxemia  arising  from  the  rapid 
decomposition  of  the  impacted  material.  These  para- 
sites were  undoubtedly  likewise,  at  least  indirectly, 
responsible  for  the  chronic  inflammation  of  the  bile 
ducts,  as  this  affection  was  not  diffuse,  but  limited  to 
circumscribed  parts  of  the  liver. 

PKIVATE   HOSPITALS    IN   AUSTRALIA. 

As  the  general  hospitals  of  Australia  make  no  pro- 
vision for  private  patients,  the  surgeons  are  under  the 
necessity  to  fill  this  gap  by  private  hospitals  in  order  to 
accommodate  the  patients  who  are  able  and  willing  to 
pay  them  for  their  services.  All  surgeons  with  a  large 
private  practice  either  own  or  patronize  a  private  hos- 
pital. Many  of  these  little  hospitals  are  operated  by 
trained  nurses.  Several  nurses  combine,  rent  a  private 
residence  in  a  desirable  locality,  convert  it  into  a  hos- 
pital and  throw  its  doors  wide  open  to  medical  men 
who  wish  to  patronize  them.  I  was  informed  that  the 
nurses  who  risk  their  time  and  money  in  such  enter- 
prizes  usually  make  them  a  success  financially.  Sur- 
geon^i  with  means,  however,  prefer,  as  a  rule,  to  build, 
own  and  manage  their  own  hospital. 

TERRACE  HOSPITAL. 

One  of  the  neatest  and'  most  attractive  private  hos- 
pitals I  ever  saw  is  the  property  of  Professor  MacCor- 
mick,  of  Sydney.  As  its  name  implies,  it  is  in  a  terraced 
tract  of  land,  three  acres  in  extent,  which  is  bisected 
by  a  deep  ravine,  shaded  by  magnificent  trees.  The  hos- 
pital, occupying  the  highest  point  of  the  romantic  little 


154  AltOUXD    THE    WORLD    VIA    INDIA. 

park,  is  a  two-story  cottage  brick  building,  with  a  gray- 
isli-white.  rough  coat  of  cement  and  a  red  tile  roof.  The 
finishing  of  the  interior,  the  arrangement  of  rooms  and 
wards,  the  heating,  the  ventilation,  the  operating  room 
equipments  and  appliances  are  as  complete  as  money 
and  skill  could  make  them.  The  building  alone  cost 
$80,000.  It  can  accommodate  40  beds.  Ten  graduate, 
salaried  female  nurses  take  care  of  the  patients.  The 
charge  for  board  and  nursing  ranges  between  $15  and 
$35  per  week.  The  large  practice  of  Professor  Mac- 
Cormick  fills  the  rooms  and  wards  throughout  the  year, 
and  the  hospital  is  prospering  financially.  One  of  the 
redeeming  features  of  these  private  undertakings  is  the 
fact  that  they  do  not  undertake  to  educate  female  nurses 
for  the  purpose  of  cutting  down  the  running  expenses, 
as  is  done  only  too  frequently  by  similar  institutions 
in  our  country. 

CLARETON   HOSPITAL. 

This  is  a  new  four-story  brick  building,  erected  and 
owned  by  Professor  Bird  of  Melbourne.  It  is  situated 
in  one  of  the  finest  streets,  almost  opposite  the  House 
of  Parliament,  and  faces  a  picturesque  park.  The  ex- 
terior of  the  building  is  pleasing  in  design  and  its  in- 
terior is  the  best  proof  that  the  plans  were  well  made 
to  meet  the  requirements  of  a  modern  hospital.  The 
cheery  operating  room  is  flooded  with  sunlight  during 
the  day  and  lighted  by  electric  lamps  at  night,  and  the 
conveniences  and  appliances  for  asepsis  are  absolutely 
perfect.  The  upper  part  of  the  building  contains  the 
living  rooms  of  the  family,  to  which  access  is  obtained 
by  an  elevator.  The  eight  graduate  nurses  employed 
to  take  care  of  the  20  patients,  the  present  capacity  of 
the  hospital,  are  well  paid,  and  the  two  matrons  receive 
$500  each  per  year. 

On  Board  S.  S.  CinNA,  Aug.  24,  1904, 


MEDICAL  EDUCATION   IX  AUSTRALIA. 


The  number  and  character  of  the  educational  institu- 
tions of  a  country  furnish  the  most  reliable  gauge  with 
which  to  estimate  the  degree  of  intelligence  of  its  people 
and  the  virtues  of  its  government.  Measured  by  this 
scale,  young  Australia  compares  well  with  America  and 
the  countries  of  the  world.  New  countries,  like  new 
cities,  have  the  great  advantage  of  profiting  by  the  ex- 
perience of  the  past,  placing  them  in  a  position  to  select 
what  has  been  found  most  useful  and  practical  and  to 
eliminate  what  has  been  proved  objectionable  by  the 
test  of  experience.  The  educational  institutions  of  the 
old  world  and  some  of  our  own  have  been  undergoing 
constant  changes  in  the  construction  of  buildings  and 
methods  of  teaching,  in  order  to  keep  pace  with  the 
rapid  strides  of  progress  and  spirit  of  investigation  and 
original  research  which  characterize  the  present  age. 
Scrutinized  in  the  light  of  the  beginning  of  the  twen- 
tieth century,  many  of  the  famous,  venerable,  moss-cov- 
ered universities  of  the  old  as  well  as  the  new  world 
appear  like  a  patched  garment  when  contrasted  with  the 
new,  vigorous  institutions  of  learning  founded,  organ- 
ized and  managed  in  accordance  with  the  most  recent 
requirements.  Viewed  from  an  educational  standpoint, 
Australia  has  reason  to  take  pride  in  what  she  has  ac- 
complished. The  government  of  this  country  has  been 
liberal  in  responding  to  the  educational  needs  of  its 
slowly  growing  and  now  almost  stationary  population. 
Its  public  schools  are  within  easy  reach  of  every  child, 
not  only  in  its  cities  and  villages,  but  wherever  a  small 
settlement  is  found  in  the  mountain  forests  and  arid 
plains.  It  has  its  grammar  and  high  schools,  colleges 
and  universities,  which   meet  all  the  necessities   of  a 


156  AliOUXD    THE    WORLD   VIA    INDIA. 

higher  and  professional  education.  It  is  a  great  mis- 
take for  any  young  Australian  man  or  woman  to  leave 
their  native  soil  in  search  of  better  opportunities  to 
qualify  themselves  for  any  position  in  life,  as  the  choic- 
est and  best  lies  at  their  very  door.  An  Oxford  or 
Cambridge  degree  will  be  of  no  more  use  to  a  profes- 
sional man  or  woman  in  Australia  or  anywhere  else  than 
a  degree  from  any  of  the  three  universities  of  the  island 
continent,  as  the  requirements  for  graduation  of  the 
latter  are  equally,  if  not  more,  stringent  than  of  the 
former.  This  southwestern  part  of  the  world  is  fully 
aware  of  what  is  going  on  in  the  way  of  scientific  prog- 
ress and  has  already  to  some  extent  contributed  its  share 
to  the  common  fund  of  knowledge,  and  is  now  in  a  po- 
sition to  become  a  more  liberal  contributor.  We  as 
physicians  are  more  especially  interested  in  the  advan- 
tages offered  by  the  Australian  universities  for  its  medi- 
cal students.  It  is  in  this  branch  of  university  educa- 
tion that  the  greatest  changes  in  the  methods  of  teach- 
ing have  been  witnessed  during  the  last  quarter  of  a 
century.  In  writing  this  communication  I  have  made 
liberal  use  of  two  addresses  delivered  by  Prof.  T.  P.  A. 
Stuart,  the  distinguished  physiologist  of  the  Sydney 
University  ("A  Review  of  University  Life  in  Australia, 
Etc.,"  and  "The  Majority  of  the  Medical  School,"  the 
latter  on  the  occasion  of  the  University  of  Sydney  cele- 
brations), and  the  last  calendars  of  the  three  univer- 
sities. The  three  Australian  universities  are  located  at 
Sydney,  Melbourne  and  Adelaide,  and  were  founded  in 
the  order  in  which  these  names  appear.  Each  university 
has  its  own  medical  department.  Fortunately  for  the 
new  country  and  its  medical  profession,  private  medical 
schools  are  out  of  the  question.  The  requirements  for 
entrance  and  graduation  are  about  the  same  in  all  of  the 
three  schools  and  I  quote  here  from  the  last  catalogue 
of  the  University  of   Adelaide : 

"Xo  person  shall  be  permitted  to  commence  the  medi- 
cal course  until  he  shall  have  completed  his  sixteenth 


AUSTRALIA.  l.")? 

year  and  havt?  inodiiccd  evidence  of  the  fact  to  the  sat- 
isfaction of  the  council.  Before  entering  on  the  medi- 
cal course  the  intending  student  must  satisfy  the  ex- 
aminers at  the  senior  public  examinations  in  the  follow- 
ing subjects :  1,  English  literature  and  English  history 
and  geography ;  2,  Latin ;  3,  arithmetic  and  algebra ; 
4,  geometry.  5,  one  of  the  following — a,  Greek;  b, 
French;  c,  German." 

The  medical  course  is  five  years.  The  examinations 
are  held  annually  in  I*Tovember  and  supplementary  ex- 
aminations may  be  held,  should  occasion  arise,  in  March. 
The  students  are  not  pestered  with  so  many  examina- 
tions as  in  some  of  our  medical  colleges  and  their  time 
is  spent  in  steady,  uninterrupted  work  instead  of  one- 
fourth  of  it  being  spent  in  cramming  for  the  frequent 
examinations,  as  is  the  case  with  some  of  our  scliools. 

The  first  examination  includes :  1,  Elementary  anat- 
omy and  dissection;  2.  elementary  biology,  theoretical 
and  practical;  3,  inorganic  chemistr}^,  theoretical  and 
practical;  4,  elements  of  physics. 

The  second  includes :  1,  Anatomy,  general  and  de- 
scriptive, with  dissections;  2,  physiolog}',  including 
practical  physiology,  histology  and  physiologic  chemis- 
try; 3,  organic  chemistry,  theoretical  and  practical, 
with  special  reference  to  physiology  and  medicine;  the 
chemistry  of  poisons,  organic  and  inorganic,  with  spe- 
cial reference  to  their  detection. 

The  third  includes :  1,  Principles  and  practice  of 
medicine;  2,  principles  and  practice  of  surgery;  3,  re- 
gional and  surgical  anatomy;  4,  materia  medica. 

The  fourth  includes:  1,  Principles  and  practice  of 
medicine,  including  clinical  medicine;  2,  principles  and 
practice  of  surgery,  including  surgical  anatomy  and 
clinical  surgery;  3.  obstetrics;  4,  forensic  medicine,  in- 
cluding insanity;  5.  patholog}^ 

The  fifth  and  last  includes:  1,  Medicine,  all  branches; 
2,  surgery,  all  branches,  including  anatomy  and  oper- 
ative surgery;  3,  gynecology;  4,  ophthalmology;  5,  otol- 
ogy; 6,  elements  of  hygiene;  7,  therapeutics. 


158  AltOLXU    TFIK    WOULD    VIA    INDIA. 

It  seems  to  me  that  the  order  of  subjects  in  these 
examinations  is  excellent,  leading  the  students  from  the 
elementary  branches  up  a  gradual  incline  to  the  most 
complicated  practical  subjects.  Anatomy  is  taught  in 
England  better  and  more  thoroughly  than  in  any  other 
country.  The  English  surgeon  is  invariably  a  good 
anatomist.  The  Australian  schools,  conducted  as  they 
are  largely  by  men  who  obtained  their  education  in 
the  United  Kingdom,  place  the  same  stress  on  this,  the 
most  important  of  all  the  primary  branches,  and  when 
their  students  graduate  they  know  their  anatomy.  X(i 
time  is  spent  in  making  skeletons  of  clay.  Gray's  Anat- 
omy and  Heath's  Dissector  are  their  text-books  and  the 
cadaver  their  ol)ject  lesson.  Professor  Watson,  of  the 
Adelaide  University,  has  little  confidence  in  lectures 
as  a  means  of  teaching  anatomy,  and  spends  most  of 
his  time  in  the  dissecting  room  with  his  students,  super- 
vising, demonstrating  and  directing  their  work.  Some 
of  the  dissections  I  examined  were  sufficient  proof  of 
the  students'  interest  and  diligence  in  acquiring  their 
knowledge  of  anatomy  and  the  efficiency  of  the  methods 
of  teaching  employed. 

The  only  fault  I  could  find  with  the  methods  of 
teaching  employed  in  the  Australian  medical  schools  is 
that  too  much  weight  is  still  given  to  didactic  lectures 
and  too  little  attention  is  paid  to  recitation  courses. 
There  are,  however,  indications  that  gradual  changes 
will  soon  reverse  this  order  of  things.  The  attendance 
at  the  medical  schools  is  necessarily  small,  the  teaching 
force,  on  the  other  hand,  in  each  school  is  large,  condi- 
tions most  favorable  for  systematic,  theoretic  teaching 
by  the  use  of  reliable  text-books,  recitations,  remarks 
and  demonstrations.  Each  of  the  three  medical  schools 
has  the  practical  control  over  a  hospital  of  300  and 
more  beds,  where  the  main  clinical  teaching  is  done.  In 
Sydney  it  is  the  Eoyal  Prince  Albert  Hospital ;  in  Mel- 
bourne, the  Melbourne  Hospital,  and  in  Adelaide,  the 
Adelaide  Hospital.     In  all  of  these  cities  the  students 


AUSTRALIA.  15  9 

liavc  also  access  to  a  cliildren's  and  other  hospitals,  the 
former  always  directl)^  or  indirectly  connected  with  the 
medical  school,  the  latter  being  available  for  extra 
mural  clinical  teaching.  Not  much  weight  is  placed, 
however,  on  the  importance  or  value  of  extra  mural 
teaching  in  any  of  the  schools.  On  the  other  hand,  the 
greatest  attention  is  given  to  laboratory  work,  and  all 
of  the  schools  have  excellent  laboratories  with  all  mod- 
ern equipments  and  appliances.  No  other  medical 
schools  in  the  world  can  offer  better  inducements  for 
their  graduates  to  obtain  an  interneship  in  a  hospital 
than  those  of  Australia.  Thus,  of  the  218  graduates  of 
the  Sydney  University  no  less  than  184  held  office  as 
resident  medical  officers  in  some  hospital,  and  growing 
hospital  facilities  will  only  increase  the  number  of  in- 
ternes in  the  future.  The  fees  for  the  whole  course  of 
five  years,  including  foes  charged  for  examination,  are 
about  $575. 

The  universities  confer  three  medical  degrees — 
Bachelor  of  Medicine,  Bachelor  of  Surgery  and  Doctor 
of  Medicine.  To  obtain  the  last  degree  a  Bachelor  of 
Medicine  or  Surgery  makes  application  one  or  two  years 
after  graduation,  writes  a  thesis  or  passes  another  exam- 
ination and,  if  satisfactory,  receives  the  degree  of  M.D. 
As  this  degree  is  more  honorary  than  useful  and  the 
obtaining  of  it  involves  another  and  not  inconsiderable 
expense,  most  of  the  practitioners  enter  on  their  life 
work  without  applying  for  it.  Many  physicians  and 
surgeons  prefer  the  plain  title  of  Mr.  to  Doctor.  All 
the  professors  receive  a  salary  of  from  $800  to  $4,500  a 
year;  in  one  or  two  of  the  universities  they  receive  a 
pension  of  $2,000  a  year  on  retirement  after  20  years' 
service. 

SYDNEY  UNIVERSITY  AND  MEDICAL  SCHOOL. 

The  Sydney  University  commenced  its  first  matricu- 
lation on  Oct.  4,  1857.  Its  courses  of  lectures  were  at 
first  restricted  to  those  required  for  the  Arts  degree; 


1(30  AROrXD    THE    world   via    INDIA. 

the  medical  school  and  the  school  of  engineering  were 
opened  in  1883,  and  the  law  school  was  opened  in  1890. 
(Figure  26).  The  teaching  staff  of  the  university  has 
gradually  increased  from  3  professors  and  2  lecturers  in 
1854  to  14  professors  and  34  lecturers  in  1899,  having 
under  their  care  519  students.  The  university  owes  a 
great  deal  to  private  benefactions.  The  total  sum  from 
this  source  at  the  close  of  1899  was  over  $2,000,000. 

The  university  building  is  a  magnificent  solid  stone 
structure  in  Gothic  style,  occupying  the  summit  of  a 
high  hill  and  surrounded  by  132  acres  of  land.  The 
Prince  Alfred  Hospital  is  located  on  the  same  grounds. 
A  large,  fine  brick  building  for  the  library  is  now  in 
process  of  construction.  The  present  chancellor  of  the 
university  is  Sir  ISTormand  MacLaurin,  a  distinguished 
Sydney  practitioner  of  medicine.  I  will  always  remem- 
ber with  pleasure  and  gratitude  the  hours  I  spent  with 
the  chancellor  in  visiting  the  university,  inspecting  its 
great  hall,  library,  rich  museum  and  the  medical  school. 
Sir  Normand  has  shown  great  tact  and  executive  ability 
in  the  management  of  this  young  but  vigorous  institu- 
tion, but  has  not  lost  his  interest  in  medicine  and  he 
takes  a  just  pride  in  the  medical  school  on  which  he 
showers  his  fostering  care.  The  university  has  now  an 
attendance  of  about  700,  of  whom  250  are  medical 
students.  Professor  Stuart  is  the  hearf  and  soul  of  the 
medical  school  and  its  present  dean. 

The  medical  school  is  the  gem  among  all  the  univer- 
sity buildings.  (Fig.  32.)  It  owes  its  origin  largely  to 
the  indefatigable  efforts  of  Dr.  H.  G.  Douglass,  Sir 
Charles  Xicholson,  Mr.  Wentworth,  Prof.  John  Smith 
and  Dr.  Richard  Greenup.  The  first  medical  school  com- 
menced its  work  in  1883  in  a  four-room  cottage.  (See 
Figure  27.)  The  palatial  new  college  building  was  com- 
pleted in  1890  at  a  cost  of  $400,000,  one  of  the  finest 
buildings  of  its  kind  in  the  world.  It  is  a  massive  stone 
building  in  imitation  of  the  university  building,  with 
tile  floors  throughout  and  inner  finishing  seldom  seen 


■••"^i^^: 


'»-'*«*t 


AUSTUALiA.  1G3 

in  a  medical  college  Statuary  and  stained  glass  win- 
dows make  one  forget  one  is  in  a  medical  college.  One 
imagines  he  is  in  a  cathedral  or  a  palace.  The  stained 
glass  windows  do  not  immortalize  saints^  l)ut  the  men 
in  our  profession,  whose  work  has  made  medicine  and 
surgery  what  they  arc  to-day.  The  inner  architecture 
corresponds  with  the  beauty  of  its  external  appearance. 
The  lecture  rooms  and  laboratories  leave  nothing  to  be 
desired.  What  a  pleasure  it  must  be  to  work  in  such  a 
building ! 

MELBOURNE    UNIVERSITY    AND    MEDICAL    SCHOOL. 

The  Melbourne  University  is  indebted  for  its  founda- 
tion to  the  public  enterprise  of  the  late  and  well-known 
English  statesman,  Mr.  Hugh  Childers,  formerly  an 
inspector  of  schools  in  the  state  of  Victoria,  and  to  Mr. 
Latrobe,  its  first  governor.  The  former  introduced  a 
bill  into  the  legislative  council  for  incorporating  and 
endowing  the  University  of  Melbourne  in  1853.  The 
bill  m'et  with  little  opposition  and  was  passed  the  same 
year.  The  university  commenced  work  with  three  pro- 
fessors and  16  students  in  April,  1855.  At  the  annual 
examinations  of  students  in  1899,  341  passed.  Its  pres- 
ent attendance  is  from  700  to  800,  of  which  number 
about  250  are  medical  students.  It  receives  an  annual 
endowment  of  $45,000  from  the  government  which, 
with  the  gifts,  bequests  and  fees,  suffice  to  meet  the 
current  expenses  and  leave  a  sufficient  residue  for  mak- 
ing improvements  as  needed.  The  buildings  are  not 
so  expensive  as  those  of  the  Sydney  University.  The 
whole  university  plant  consists  of  a  group  of  buildings, 
each  of  which  is  devoted  to  the  department  for  which 
it  is  intended.  For  instance,  the  medical  school  is  made 
up  of  a  number  of  separate  one-story  stone  or  brick 
buildings,  representing  as  many  departments.  Mel- 
bourne Hospital  and  the  Children's  Hospital  furnish 
the  clinical  material.  Professor  Allen  is  dean  of  the 
medical   faculty  and   professor   of   anatomy   and    path- 


10-i  AROUND  THE  WORLD  VIA  IXDIA. 

ology.  He  is  a  remarkable  man.  He  is  a  graduate  of 
the  university  and  has  acquired  his  professional  knowl- 
edge of  anatomy  and  pathology  by  the  hardest  kind  of 
work  within  the  shadows  of  his  beloved  alma  mater. 
The  choicest  fruit  of  his  ceaseless  labor  has  been  a 
pathologic  museum  containing  thousands  of  the  most  in- 
teresting specimens,  which  he  has  prejDared  and  labeled 
with  his  own  hands.  Besides  this,  he  keeps  a  record  of 
all  the  findings  of  the  postmortem  examinations  at  the 
Melbourne  Hospital  and  has  also  filed  away  the  clinical 
history  of  each  case.  I  believe  he  could  walk  through 
the  great  museum  hall  and  pick  out  any  particular 
specimen  blindfolded;  not  only  this^,  but  he  could  give 
the  astonished  visitor  a  minute  description  of  them  all. 
He  showed  and  demonstrated  to  me  scores  of  the  rarest 
and  most  interesting  specimens.  He  has  one  of  the  fin- 
est collections  illustrative  of  the  pathologic  anatomy  of 
hydatid,  actinomycosis  and  bone  disease.  He  relies 
on  wood  alcohol  in  the  preparation  and  preservation  of 
the  specimens.  The  specimen  jars  are  covered  with 
heavy  tin  foil,  which  can  be  removed  and  replaced  with 
the  utmost  ease,  and  the  tin  foil  cover  properly  applied 
over  the  mouths  of  the  jars  effectually  prevents  the  evap- 
oration of  the  liquid,  the  loss  during  a  year  from  this 
source  being  insignificant.  Professor  Allen  has  become 
satisfied  from  his  immense  experience  that  malignant 
disease  among  the  aborigines  is  extremely  rare ;  on  the 
other  hand,  syphilis  is  very  common.  Everything  in 
his  museum  shows  system  and  order,  a  beautiful  and 
rich  workshop  for  anyone  who  seeks  information  in  this 
branch  of  medical  study  and  teaching.  Professor  Allen 
knows  how  to  get  the  best  work  from  his  students.  He 
has  published  a  little  inter-leaved  book,  "Pathological 
and  Histological  Methods  of  Sections,"  for  the  junior 
students,  in  which  a  brief  description  is  given  of  the 
mechanical  part  of  the  work  and  the  blank  pages  are 
filled  in  by  the  students  with  notes  and  drawings.  A 
similar  plan  is  followed  in  the  baeteriologic  laboratory. 


AUSTKALIA.  1G5 

ADELAIDE  UNIVEltSITY  AND  MEDICAL  SCHOOL. 

Tlic  University  of  Adelaide,  the  youngest  and  small- 
est of  tiie  Australian  universities,  was  incorporated  in 
1874.  It  commenced  work  two  years  later  with  the 
Arts  course.  Other  schools  were  gradually  added  until 
the  university  was  able  to  give  its  students,  besides  de- 
grees in  arts,  degrees  in  law,  medicine,  science,  music, 
agriculture  and  engineering.  It  receives  a  substantial 
government  aid  and  has  been  endowed  by  a  numl^er 
of  handsome  donations  and  bequests,  among  them  one 
of  $480,000  by  the  late  Sir  Thomas  Elder.  The  Elder 
Conservatory  of  Music,  opened  in  1898,  commemorates 
this  munificent  gift.  Its  present  attendance  does  not 
exceed  400,  of  whom  about  120  are  medical  students. 
The  primary  branches  of  the  medical  school  are  taught 
in  separate  buildings.  The  anatomy  building,  the  real 
home  of  Professor  Watson,  is  a  large  one-story  brick 
building.  Here  he  dwells  among  his  students  from 
morning  until  dusk,  often  unconscious  of  the  lunch 
hour,  his  mind  bent  on  unraveling  the  mysteries  of 
human  anatomy  and  in  supervising,  directing  and  en- 
couraging the  students  in  their  work.  If  any  new  dis- 
covery is  made  in  anatomy  anywhere  in  the  world  he  is 
sure  to  learn  of  it,  test  it,  and  make  use  of  it  in  his 
teachings.  He  takes  special  delight  in  demonstrating 
to  his  students  Byron  Eobinson's  utero-ovarian.  circle. 
He  fully  appreciates  the  importance  of  applied  anatomy 
and  never  loses  an  opportunity  to  show  the  intimate 
relationship  between  it  and  operative  surgery.  A  visit 
to  Adelaide  without  seeing  and  knowing  this  inter- 
esting man  would  be  about  as  unprofitable  as  a 
journey  to  Eome  without  seeing  the  pope  or  at  least 
making  a  visit  to  the  Cathedral  of  St.  Peter.  Another 
most  interesting  member  of  the  medical  faculty  of  Ade- 
laide University  is  Professor  Stirling,  professor  of 
physiology  and  director  of  the  natural  history  museums. 
A   combination  of   these  two  important  offices  makes 


1G6  AROUND  THE  WORLD  VIA  INDIA. 

him  one  of  the  busiest  men  in  Adelaide.  He  is  equally 
at  home  in  his  physiologic  institute  as  in  the  great  hall 
of  the  museum  crammed  from  floor  to  ceiling  with  the 
choicest  specimens  of  the  animal  and  vegetable  king- 
doms of  his  own  country  as  well  as  from  all  parts  of 
the  world,  and  the  products  of  man's  ingenuity  from  the 
stone  age  up  to  the  most  recent  inventions.  This  part 
of  his  work  is  to  him  a  labor  of  love.  He  has  made  this 
museum  what  it  is,  the  best  in  Australia  and  the  peer 
of  many  in  countries  that  count  their  age  by  centuries. 
From  what  has  been  stated  it  must  become  clear  to  any- 
one that  the  Australian  universities  offer  to  medical 
students  advantages  and  opportunities  equal  to  if  not 
superior  to  any  of  the  medical  schools  of  America  and 
the  United  Kingdom.  It  would  be  folly  for  any  Aus- 
tralian medical  student  to  cross  the  ocean  in  either  di- 
rection in  search  of  something  better,  because  if  he  did 
he  would  certainly  meet  with  keen  disappointment. 
Colombo,  Ceylon,  Aug.  25,   1904. 


CEYLON. 

FROM    AUSTRALIA    TO    (JEYLON — ISLAND    OF    CEYLON,    ITS 
CLIMATE,    PEOPLE,    DISEASES — COLOMBO    (iENERAL 

CIVIL   HOSPITAL CEYLON   MEDICAL   COLLEGE 

CEYLON   LEPER   COLONY — LEPER    BUDDHIST 

CELEBRATION — KANDY    GENERAL 

CIVIL    HOSPITAL. 


The  voyage  from  Adelaide  to  Colombo  takes  fourteen 
days.  I  left  Adelaide  August  11  and  arrived  at  Co- 
lombo on  the  24th,  a  little  ahead  of  the  stipulated  time. 
The  only  rough  weather  we  encountered  was  for  four 
days  in  crossing  the  great  Australian  Bight,  a  part  of 
the  ocean  that  has  an  unenviable  reputation  with  people 
who  are  subject  to  seasickness.  Our  good,  staunch, 
storm-tried  ship,  the  China,  played  with  the  foam- 
crested  waves  by  a  graceful  combination  of  rolling  and 
pitching  which,  unavoidable  and  well  intended,  brought 
about  the  usual  result — reversion  of  the  peristaltic  ac- 
tion of  the  stomach — in  a  fair  percentage  of  cases 
among  the  small  number  of  passengers.  It  seemed  to 
me,  however,  that  the  Australian  and  English  people 
are,  on  the  whole,  less  susceptible  to  seasickness  than 
the  more  nervous  Americans,  and  a  number  of  the  lady 
passengers  always  occupied  their  places  at  the  table 
during  meal-time.  A  few  hours'  stop  was  made  at 
Fremantle,  which  gave  me  an  opportunity  to  see  this 
important  western  port  of  Australia  and  from  there 
make  an  excursion  by  rail  to  Perth,  12  miles  distant. 
Perth  is  a  new  and  modern  city  with  25,000  inhabi- 
tants. The  activity  in  the  principal  streets  reminds 
one  very  much,  at  least  on  a  small  scale,  of  State  Street 
in   Chicago.     The  business   importance  of  both   these 


168  AlfOUXD  THE  WOKLD  VIA  INDIA. 

western  Australian  cities  depends  largely  on  the  rich 
gold  mines  in  that  section  of  the  country.  Fremantle 
has  a  public  hospital  with  accommodations  for  40  pa- 
tients ;  the  hospital  at  Perth  is  a  new  and  modern  build- 
ing with  a  capacity  for  200  patients.  As  we  left  the 
harbor  of  Fremantle  we  were  followed  by  our  faithful 
escort  of  albatrosses,  which  had  never  deserted  us  in  the 
open  ocean  since  we  left  the  New  Zealand  coast,  but  on 
this  occasion  these  magnificent  living  kites  of  the  air 
left  us  at  dusk  the  first  day  out,  never  to  return.  With 
the  exception  of  occasional  schools  of  flying  fish,  water 
and  air  were  sterile  from  coast  to  coast.  Cool  weather 
continued  for  two  days  after  leaving  Fremantle,  when 
the  winds  gradually  subsided,  the  sun  displayed  his 
tropical  properties  and  the  drizzling  rains  saturated  the 
atmosphere  with  moisture,  all  of  which  made  the  heat 
very  oppressive.  Blankets  and  heavy  clothing  were 
laid  aside  and  the  officers  set  the  example  for  the  wear- 
ing of  clothes  appropriate  for  the  tropics.  The  low 
palm-fringed  coast  of  Ceylon,  lightly  veiled  in  a  rising 
fog,  came  in  sight  Wednesday  morning  and  during  the 
forenoon  we  were  comfortably  quartered  at  the  Grand 
Oriental  Hotel,  Colombo. 

CEYLON. 

The  island  of  Ceylon,  called  Singhala  by  the  natives, 
is  about  55  miles  from  the  southern  extremity  of  Hin- 
dustan, from  which  it  is  separated  by  Palk  Strait.  It 
lies  between  5°  and  9°  N.  latitude,  hence  in  the  very 
midst  of  the  tropics.  The  interior  is  mountainous,  the 
highest  peaks  l)eing  Pedrat,  Allagalla  and  Adams' 
Peak;  the  former  rises  to  an  altitude  of  8,200  feet,  the 
latter  7,420  feet.  The  island  is  noted  for  its  tropical 
forests,  impenetrable  jungles  and  luxurious  vegetation. 
This  island  has  had  an  eventful  political  history.  It 
was  taken  possession  of  by  the  Portuguese  in  the  seven- 
teenth century,  passed  later  into  the  hands  of  the  Dutch 
by  conquest,  and  was  finally  annexed  to  the  British 


CEYLON.  !<)'.» 

crown  ill  111'.").  'V\\v  two  lli-st  natidiis  never  conquered 
the  entire  island,  and  the  British  forces  underwent 
many  hardsliips  and  met  with  fierce  opposition  in  the 
interior  of  the  ishmd  before  the  last  rebellion  was  sup- 
pressed in  1817.  Since  that  time  the  peace  of  the 
island  has  never  been  disturbed  and  it  has  become, 
under  a  wise,  conservative  government,  the  wealthiest 
and  most  i)rospcrous  colony  of  the  British  empire.  Tlie 
principal  articles  of  export  are  tea,  coffee,  cinnamon, 
cacao  and  cinchona  bark.  The  cocoanut  palm,  which  is 
found  here  in  all  its  productiveness  along  the  seashore, 
in  the  lowlands,  valleys  and  high  up  on  the  hillside, 
not  only  furnishes  the  natives  with  a  considerable  part 
of  their  sustenance.  l)ut  is  an  important  source  of  reve- 
nue. The  annual  value  of  the  produce  of  this  tree  alone 
amounts  to  $10,000,000.  In  looking  at  the  palm  forests 
of  Ceylon  no  one  could  forget  what  this  tree  does  for 
tlie  untutored  natives,  as 

"It  is  meat,  drink  and  clothes  to  us." — Rabelais. 
And  one  who  would  not  think  almost  instinctively  of 
the  beautiful  words  of  the  psalmist : 

"The  righteous  shall  flourish  like  the  palm  tree; 
he  shall  grow  like  a  cedar  in  Lebanon." — 
Psalms  xcii,    12. 

Ceylon  supplies  the  markets  of  the  world  with  cin- 
chona bark,  amounting  to  about  a  million  of  pounds  a 
year.  The  cinnamon  tree  is  indigenous  and  reaches  a 
height  of  from  40  to  60  feet  and  a  circumference  of 
from  3  to  6  feet.  The  cinnamon  bark,  however,  is  not 
obtained  from  the  old  trees,  but  from  annual  shoots 
from  a  very  short  stump,  which  is  pruned  and  sprouts 
from  year  to  year.  Another  important  source  of  reve- 
nue is  the  more  than  4,000  gem  quarries.  Ceylon  has 
now  more  than  1,500  miles  of  railway,  over  2,000 
schools,  36  newspapers  and  upward  of  100  hospitals  and 
dispensaries.  The  Ceylon  tea  is  the  best  in  the  world, 
and  since  it  has  been  found  that  the  hardy  shrub  which 
ijrows  this  commodity  will  thrive  best  at  an  altitude  of 


170  AKOIXD    TlIK    \V()I;LD    via    INDIA. 

7,0U0  feet,  the  forests  are  rapidly  making  way  for  the 
tea  industry  up  to  an  altitude  of  6,000  feet.  As  an 
important  protection  against  deforestation  from  this 
and  the  timher  industry  the  government  has  wisely 
stopped  the  sale  of  timber  land  above  an  altitude  of 
more  than  6,000  feet.  Ceylon  is  the  paradise  for  the 
hunter,  as  large  herds  of  elephants  still  inhabit  the 
jungles  at  a  safe  distance  from  human  habitations  and 
buffalo,  elk,  deer,  bear  and  wild  boar,  as  well  as  a  great 
variety  of  birds,  are  quite  plentiful  and  furnish  the 
best  opportunities  for  most  interesting  sport.  The 
scientist  finds  here  an  endless  field  for  study  and  inves- 
tigation. The  great  fertility  of  the  soil,  the  copious 
rains  and  the  variations  in  the  climatic  conditions  on 
different  parts  of  the  island  have  created  a  vegetation 
noted  for  its  luxuriance  and  endless  variety.  The  for- 
est trees  alone  are  a  great  attraction.  We  find  here  the 
satin,  sandal  and  ebony  trees,  from  which  the  most 
valuable  timber  is  obtained.  It  may  not  be  generally 
known  that  less  than  one-third  of  the  wood  of  the 
ebony  tree  {Diospyros  ehenuni)  is  black,  and  this  is 
found  in  the  center  of  the  stem;  the  outer  two-thirds  of 
the  wood  is  white  and  without  value.  In  the  botanical 
garden  at  Kandy  I  saw  an  India  rubber  tree  (Ficus 
elaMica).  planted  by  the  Dutch  in  1833,  which  has 
reached  a  height  of  130  feet,  and  the  multiple  stems 
and  their  colossal  branches  cover  a  circular  area  where 
several  hundred  people  could  find  protection  against 
rain  and  sunshine  at  the  same  time  and  be  much  less 
crowded  than  in  the  streets  of  Kandy  at  a  Buddhist 
celebration.  In  the  same  place  I  saw  a  nux  vomica  tree 
more  than  50  feet  high  with  a  graceful  crown  of  small 
elongated  deep  green  leaves  in  a  state  of  budding  for 
the  next  year's  crop  of  disc-like  nuts  so  familiar  to  the 
physician  as  the  source  of  strychnin.  The  bo-tree  (Ficus 
re.ligiom)  is  one  of  the  giants  of  the  forests.  Its  broad 
acuminate  leaves  tremble  in  the  breeze  like  the  leaves 
of  our  aspen.    The  trunk  is  very  short  and  from  the  top 


CF.YLOX.  171 

the  treelike  branches  ionn  a  wide-spreading  crown. 
This  tree  is  worshipped  and  is  held  in  great  veneration 
by  the  Buddhists.  A  very  strange  tree  is  what  is 
known  as  the  jack  tree,  a  large  tree  which  bears  the 
largest  edible  fruit  known.  The  fruit  is  suspended 
from  the  trunk  and  the  larger  branches  by  a  short  stalk, 
and  in  several  instances  it  sprouts  from  exposed  roots. 
The  edible  part  of  the  fruit  is  a  yellow  pulpy  viscid 
mass.  The  smell  and  taste  of  the  fruit  when  ripe  are 
strong,  and  to  the  European  unpleasant,  but  the  flavor 
is  akin  to  that  of  our  may  apple  and  quite  agreeable,  at 
least  it  proved  so  to  me.  The  elephant  is  very  fond  of 
the  leaves  of  this  tree.  The  Areca  palm,  a  very  slender 
tree,  grows  a  nut  which  bears  in  its  structure  a  close 
resemblance  to  the  nutmeg.  This  nut,  scraped  and 
mixed  with  a  white  paste  made  of  slacked  lime,  served 
on  a  green  leaf,  is  the  hetel  so  much  in  use  by  the  na- 
tives as  a  chewing  material.  This  practice  is  no  worse 
from  a  hygienic  and  esthetic  standpoint  than  the  chew- 
ing of  gum  and  tobacco  by  Americans,  but  the  betel 
contains  a  red  coloring  material  and  its  habitues  do  not 
improve  their  looks  by  the  red  lips,  tongue  and  teeth, 
which  looks  to  the  uninitiated  very  much  as  .though  the 
chewers,  instead  of  enjoying  the  pastime,  might  be  the 
subjects  of  purpura  hemorrhagica,  or  had  just  escaped 
from  the  chair  of  an  aggressive  dentist.  How  helpless 
the  practitioner  of  medicine  would  be  if  Ceylon  did  not 
supply  him  with  cinchona  and  nux  vomica,  to  say  noth- 
ing of  cloves,  cinnamon,  cajeput,  pepper,  nutmeg  and 
other  aromatics  and  carminatives  with  which  we  are  in 
the  habit  of  disguising  the  taste  and  smell  of  more  pow- 
erful drugs  and  which  often  prove  so  efficacious  in  the 
treatment  of  slight  gastro-intestinal  derangements.  But 
there  are  still  more  remarkable  trees  in  Cevlon,  which 
prove  the  perfect  foresight  of  the  Creator  in  meeting 
urgent  wants  of  man  and  beast.  Wherever  there  are 
cocoa  palms,  man's  immediate  wants  arc  met,  as  it  sup- 
plies him  with  drink  and  meat;  the  milk  of  the  unripe 


172  AROUXD    THE    WORLD   VIA    INDIA. 

fruit  will  quench  his  thirst  and  the  meat  of  the  ripe 
nut  supplies  him  with  food.  The  rain  tree  (Inga  sausa) 
is  a  large  tree  with  thick,  short  stems  and  widely- 
spreading  branches.  Around  the  lake  of  Kandy  these 
trees  are  of  enormous  size.  It  has  a  pinnatifid  leaf  like 
the  acacia.  In  the  evening  these  leaflets  fold  them- 
selves into  a  small  cup,  in  which  the  falling  dew  is  col- 
lected and  retained  until  simrise,  when  it  unfolds,  and 
in  doing  so  the  thousands  of  drops  of  water  give  rise 
to  a  shower  on  a  small  scale,  hence  the  name  "rain 
tree." 

Ceylon  is  the  home  of  a  great  variety  of  palms.  Of 
these  the  talipot  palm  is  one  of  the  most  remarkable. 
For  the  first  ten  years  it  grows  only  from  scaped  leaves. 
Next  the  stem  grows  as  straight  as  a  mast  to  a  height 
of  100  feet.  Each  annual  growth  is  indicated  by  a 
ring.  The  fan-shaped  leaves  are  of  enormous  size, 
somietimes  15  feet  in  radius.  They  are  so  large  that 
three  leaves  make  an  ample  and  waterproof  tent.  The 
leaf,  cut  into  pieces  of  convenient  size,  has  been  used 
for  centuries  as  a  substitute  for  writing  paper. 

In  the  octagonal  tower  of  the  Temple  of  the  Tooth 
at  Kandy  thousands  of  manuscript  volumes  record  the 
early  history  of  India  on  strips  of  the  leaves  of  this 
palm.  When  the  tree  reaches  maturity  it  develops  a 
gigantic  bud  at  the  end  of  a  pole-like  prolongation  pro- 
jecting 10  to  15  feet  above  the  crown  of  fronds.  This 
bud  in  due  time  bursts  with  a  report  and  a  lovely  white 
blossom  unfolds  itself  and  spreads  with  a  pyramid  of 
cream-colored  flowers.  After  this  final  act  of  propa- 
gating its  species  the  tree  soon  sickens  and  dies.  It 
was  my  fortune  to  see  one  of  these  trees  a  very  short 
time  after  bursting  of  its  pod  and  expansion  of  the  lib- 
erated flowers.  The  imdergrowth  in  forest  and  jungle 
is  represented  by  a  variety  of  shrubs,  the  principal  one 
being  the  nulu. 

The  density  of  the  forest  is  increased  by  twining 
plants,  many  of  which,  especially  the  Thimbergia,  with 


CEYLON.  ii-> 

its  beautiful  pale  blue  flowers,  roacli  to  the  very  top^ 
of  the  highest,  trees.  Orchids,  pitcher  plants,  the  gor- 
geous passion  flower  and  several  species  of  rhododen- 
drons arc  worthy  representatives  of  the  rich  flora  of  the 
island. 

CLIMATE. 

When  Nature  goes  to  work  to  create  a  botanic  garden 
she  must  necessarily  have  at  her  disposal  a  fertile  soil 
and  a  hot,  moist  climate,  a  climate  congenial  to  luxuri- 
ous vegetation,  but  hostile  to  man.  Such  is  the  climate 
of  Ceylon.  The  intensity  of  the  heat  is  made  almost  in- 
tolerable during  the  rainy  season,  from  February  to 
July,  by  the  saturation  of  the  air  with  moisture.  When 
I  arrived  at  Colombo  the  rainy  season  was  practically 
over  and  yet  the  atmosphere  was  so  surcharged  with 
moisture  that  in  the  absence  of  a  breeze,  natural  or  arti- 
ficially produced  by  fan  or  punkah,  breathing  was  a 
difficulty  and  the  sense  of  heat  distressing,  although  the 
thermometer  in  the  shade  only  showed  a  temperature 
of  92  degrees  F.  The  coolest  months  are  October,  j^o- 
vember,  December  and  January,  and  the  hottest  corre- 
spond with  our  spring  months.  In  Colombo  it  is  al- 
ways hot  and  the  use  of  blankets  is  almost  unknown. 
The  continuous  heat  from  one  end  of  the  year  to  the 
other  is  depressing  and  Europeans  find  it  necessary  to 
seek  a  cooler  climate  every  three  or  four  years  to  re- 
cuperate, and  have  to  abstain  from  hard  work,  mental 
and  physical,  as  much  as  possible  during  their  entire 
residence.  In  the  mountains  at  an  elevation  of  2,000 
and  more  feet  the  nights  are  cool,  and  even  at  Kandy, 
1,600  feet  above  the  level  of  the  sea,  the  nights  are 
often  chilly.  The  chains  of  mountains  traversing  the 
island  have  a  marked  influence  on  the  rainfall  and  tem- 
perature of  the  high  altitudes.  It  is  often  the  case  that 
on  one  side  of  the  range  it  is  sultry  and  fogs  and  rain 
prevail,  wdiile  on  the  opposite  side  the  atmosphere  is 
dry  and  cool  and  a  bright  sunshine  adds  to  the  cheer- 


174:  AROUXD    THE    WORLD    VIA    IXDIA. 

fulness  of  the  bracing  mountain  climate,  with  a  re- 
versal of  climatic  conditions  occurring  with  a  change  of 
the  prevailing  winds.  It  is  well  known  that  a  pro- 
longed residence  in  Ceylon  shortens  the  lives  of  the 
Europeans,  and  consequently  those  who  are  obliged  to 
live  there  find  themselves  under  the  necessity  of  leaving 
the  island  every  few  years  for  several  months  in  order 
to  rid  themselves  of  that  lassitude  and  depression  inci- 
dent to  a  prolonged  residence  in  the  tropics,  and  to 
regain  their  recuperative  power  that  is  so  essential  in 
resisting  the  insidious  influences  of  tropical  and  other 
diseases. 

THE  PEOPLE. 

The  population  in  1891  was  3,008.460.  The  natives 
are  increasing  very  rapidly,  as  the  estimated  population 
of  the  island  on  Dec.  31,  1902,  was  3,685,267.  This  is 
confirmed  by  the  birth  and  death  rate  for  the  same 
3'ear;  141,893  births  were  registered  and  99.680  deaths. 
The  birth  rate  was  39.  against  37.5,  and  the  death  rate 
of  27.4  against  27.6  per  mille  in  the  previous  year  on 
the  estiiuated  population  in  the  middle  of  the  year 
(Medical  Eeport  of  Dr.  Allan  Perry,  principal  civil 
medical  officer  and  inspector  general  of  hospitals,  1902). 
This  record  is  not  in  accord  with  the  fate  of  our  Indians 
and  the  Polynesians  of  the  islands  of  the  Pacific,  whose 
rapid  decimation  and  eventual  extermination  followed 
so  promptly  the  footsteps  of  civilization.  Three  expla- 
nations deserve  consideration  in  accounting  for  this 
difference.  The  Ceylonese  have  for  centuries  been  in 
touch  with  the  outside  world  by  much  frequented 
waterways  and  thev  have,  perhaps  more  than  any  other 
primitive  race,  retained  more  persistently  their  original 
habits,  and  as  most  of  them  are  Buddhists  they  have 
escaped  the  fearful  consequences  of  alcoholism  so  com- 
mon among  other  savage  races  as  soon  as  the  white 
man  satisfies  their  morliid  desire  for  liquor.  The  Sin- 
ghalese and  Tamil  do   not  encuml^cr  themselves  with 


Fig.    33. — A    Singhalese. 


CKYLOX.  177 

Eiiropean  clothes;  tlio  coinboy  (loin  cloth)  is  the  only 
article  of  dress  which  ho  makes  use  of,  and  which  con- 
tinues to  satisfy  all  his  needs  as  far  as  appearance  and 
protection  are  concerned.  The  diet,  habits  and  manner 
of  living  remain  the  same.  (Fig.  33.)  The  population 
of  Ceylon  is  a  very  mixed  one,  consisting  of  Singhalese. 
Tamil,  Portuguese,  Dutch,  Malays,  Parsees,  Turks, 
Afghans  and  half-castes  of  all  shades  of  color  between 
almost  pure  white  and  jet  black.  The  Singhalese  and 
Tamils,  however,  form  the  bulk  of  the  population.  The 
Europeans  are  in  a  very  small  minority.  The  Tamils 
are  the  Indian  coolies  who  immigrated  from  the  south- 
western part  of  India  and  became  the  laborers  of  the 
planters  in  the  interior  uplands  of  the  island.  The 
Singhalese  are  averse  to  hard  labor  and  have  always 
shown  a  preference  for  the  plains  and  valleys.  The 
Tamils  are  a  low  race,  far  beneath  the  Singhalese  in 
intelligence.  The  Singhalese  is  proud  of  his  race. 
Half-castes  bear  the  humiliation  brought  on  them  by 
the  admixture  of  European  blood  with  a  becoming  pa- 
tience and  fortitude,  but  they  regard  the  accident  of 
their  birth  rather  as  a  disadvantage  than  otherwise  in 
their  social  position  and  best  possibilities  in  life.  The 
question  of  caste,  even  in  Ceylon,  plays  quite  an  impor- 
tant role,  consequently  the  Singhalese  and  Tamil  sel- 
dom intermarry.  The  former  is  a  gentleman  by  birth, 
and  as  such  is  averse  to  menial  work,  for  which,  if  he 
can  afford  it,  he  hires  the  man  of  burden,  the  lowly- 
born  Indian  coolie,  who  in  most  respects  resembles  the 
low-caste  Chinese  and  Japanese.  The  Singhalese  is  a 
very  fine  specimen  of  manhood,  tall,  slender,  with  long, 
very  thin  legs,  face  clean  cut  with  regular  outlines, 
well-shaped  nose,  high  forehead,  black  eyes,  bushy  eye- 
brows of  the  same  color,  delicate  hands,  and  in  com- 
plexion varies  from  a  sienna  to  almost  as  black  as  the 
negro.  The  hair  is  long  and  straight  or  wavy  and  is 
worn  by  combing  it  back  or  parting  it  in  the  middle, 
tied  behind  into  a  knot,  which  is  surmounted  by  a  semi- 


175  AROUND    THE    WORLD   VIA    IXDIA. 

circular  comb  of  tortoise  shell.  The  manner  of  wearing 
the  hair  and  the  delicate  face  in  the  young  men  with 
scanty  beard  and  similarity  in  dress  makes  it  often  very 
difficult  to  distinguish  between  the  two  sexes  before 
advancing  age  draws  more  distinct  facial  lines.  The 
young  men  appear  ver)"  effeminate,  more  so  than  in 
any  other  race  that  I  have  ever  seen.  Tailors  and  shoe- 
makers do  very  little  business  in  Ceylon.  With  a  few 
yards  of  cloth  men  and  women  drape  themselves  very 
gracefully,  leaving  at  least  one-half  of  the  body  uncov- 
ered. The  comboys  differ  only  in  length  from  a  narrow 
strip  of  cloth  to  a  petticoat  reaching  below  the  knees, 
worn  by  some  men  and  all  the  women.  Another  two  or 
three  yards  thrown  over  the  left  shoulder  covers  at 
least  a  part  of  the  chest  and  leaves  the  right  arm  unen- 
cumbered. Hair  and  skin  are  kept  saturated  with  palm 
oil,  a  very  important  hygienic  measure,  as  it  preserves 
the  hair  and  protects  the  skin  against  the  burning  rays 
of  the  Sim.  rain  and  insects.  The  Singhalese  are  almost 
free  from  baldness,  as  they  do  not  injure  the  nutrition 
of  the  hair  follicles  by  the  use  of  harmful  head-dress 
and  make  free  use  of  palm  oil,  which  is  undoubtedly  an 
important  nutrient  to  the  hair  and  the  hair  follicles. 
(Fig.  34.)  The  women  are  much  smaller  than  the  men 
and  can  make  no  pretensions  to  beauty.  The  flush  of 
youth  begins  to  decline  before  they  are  30  years  old, 
and  then  they  are  inclined  to  obesity.  They  are  fond  of 
jewelry.  Many  of  them  cling  to  nose  and  ear  rings, 
toe  rings,  wristlets,  anklets  and  arm  bands  of  silver. 
The  Singhalese  has  many  excellent  qualities;  he  is 
cheerful,  content,  honest  and  peaceable.  Theft  and  rob- 
bery are  almost  unknown.  Willful  premeditated  mur- 
der is  very  rare.  During  the  year  1903,  36  men  were 
sentenced  to  death  for  murder,  and  of  these  22  were 
hanged ;  in  the  other  cases  the  sentence  of  death  was 
commuted  to  long  terms  of  imprisonment.  Major  de 
Wilton,  inspector  of  police  (Prison  Eeport,  1903) 
makes  the  followinir  couiments  on  the  crime  of  murder: 


Fig".    34. — Singhalese   woman. 


CKVLOX.  LSI 

"It  is  very  dilliiiilt  to  iiiake  any  conjecture  as  to  the 
cause  of  the  prevalence  of  the  crime  oL'  niurdci-.  The 
offenders  do  not,  as  has  heen  repeatedly  pointed  out, 
helong  to  the  criminal  class.  They  are,  as  a  rule,  men 
without  previous  convictions,  who  up  to  the  time  of  the 
crime  have  led  a  comparatively  hlameless  life.  The 
offense  is  not  generally  committed  with  the  delihera- 
tion  of  the  hardened  criminal,  hut  in  tlie  fiery  heat  of 
passion  or  under  the  influence  of  liquor,  and  it  is  a  mat- 
ter of  regret  that  even  the  death  penalty  hrings  with  it 
no  direct  effect." 

The  knife  is  the  implement  most  frequently  used 
when  violence  is  resorted  to.  The  number  of  persons 
committed  to  prison  for  all  kinds  of  offenses  during 
the  year  1903  was  2,396,  a  figure  which  shows  well  for 
the  morale  of  the  island.  Of  2,508  convictions  during 
the  year  1903,  49  were  Protestants,  361  Eoman  Catho- 
lics, 1,509  Buddhists,  314  Hindoos,  260  Mohamme- 
dans; other  religions  15.  Notwithstanding  the  heroic 
labors  of  missionaries  of  different  denominations  for 
the  last  two  centuries  and  the  expenditure  of  millions 
in  efforts  to  convert  the  natives,  the  results  have  been 
very  unsatisfactory.  The  mass  of  the  people  cling  to  their 
Buddhist  faith  with  great  tenacity.  The  bareheaded, 
barefoot,  yellow-robed  priests  remain  in  power  and  at- 
tend to  the  spiritual  needs  of  the  people.  The  Eoman 
Catholic  church  has  accomplished  more  than  any  other 
denomination.  Those  who  have  abandoned  Buddhism 
and  have  joined  a  church  do  not  always  live  in  accord- 
ance with  the  teachings  of  the  new  religion  and  continue 
many  of  their  former  customs  and  practices,  which 
perhaps  unconsciously  cling  to  them  from  force  of  habit. 
For  instance.  Christianity  has  made  very  little  impres- 
sion on  the  morality  of  the  people.  The  natives  are  a 
temperate  people,  as  the  teachings  of  Buddha  prohibit 
the  use  of  alcohol  in  any  form,  and  with  few  exceptions, 
indeed,  the  Buddhists  are  total  abstainers.  The  Sin- 
ghalese  have   taken    kindly   to   the   professions.      The 


182  AROUND    THE    WOULD   VIA    IKDIA. 

most  prominent  and  successful  physicians  and  lawyers 
in  Ceylon  are  natives  or  half-castes. 

PREVAILING  DISEASES. 

The  bubonic  plague  has  never  had  a  foothold  iii 
Ceylon.  This  is  the  more  remarkable,  as  its  harbors 
are  visited  daily  by  ships  from  all  Oriental  ports  and 
the  exemption  from  this  scourge  must  be  due  to  the 
extraordinary  care  exercised  by  the  department  of 
health.  Accurate  information  regarding  the  present 
prevailing  diseases  can  be  gleaned  from  the  Annual 
Keport  of  Dr.  Allan  Perry,  principal  medical  officer  of 
the  island. 

Malaria. — In  the  western,  central  and  north  central 
provinces  malarial  fevers  were  very  slight.  The  disease 
is  most  prevalent  in  the  northwestern  and  eastern 
provinces.  The  disease  is  quite  prevalent  in  Colombo, 
and  observations  are  now  being  made  to  determine  the 
places  where  infection  takes  place. 

Cholera. — During  the  year  1902,  according  to  this 
report,  there  were  179  cases  of  cholera,  with  116  deaths. 
The  largest  number  of  cases  occurred  in  Colombo  and 
vicinity. 

S  1)1  all  pox. — Tliere  were  146  cases  of  this  disease, 
with  35  deaths,  in  the  north  of  the  island,  and  118 
cases  were  admitted  to  the  Infectious  Diseases  Hospital. 
Kanatta,  which,  with  two  from  another  province,  made 
120,  with  32  deaths. 

Dj/s-fntery. — This  disease  is  equally  distributed 
throughout  the  island.  It  was  most  prevalent  in  the 
central  and  western  provinces.  The  largest  number 
treated  in  any  one  institution  was  at  the  General  Hos- 
pital, Colombo,  where  488  cases  were  admitted,  of  whom 
89  died. 

Enteric  Fever. — The  number  of  cases  treated  in  the 
various  hospitals  throughout  the  island  was  242,  with 
63  deaths.  Pollution  of  water  and  milk  are  the  com- 
monest  causes    of   this    di<ea';o.      The   cesspit    system, 


CEYLON.  183 

wliirli  exists  in  some  of  tlie  large  towns,  notably  Co- 
lombo, Kandy  and  Gallo,  lias  miicli  influence  in  increas- 
ing the  number  of  cases. 

Leprosy. — The  total  number  of  cases  reported  during 
the  year  1902  was  560,  against  590  in  the  previous  year, 
being  a  decrease  of  30  cases;  382  cases  were  treated  in 
the  leper  asylum,  Hendala,  and  30  in  the  Kalmunai 
wards.  The  leper  ordinance  came  into  operation  at  the 
beginning  of  the  year,  and  113  cases  have  been  reported. 

An'k.ylostomiasis. — It  seems  that  this  disease,  which  is 
so  very  prevalent,  is  constantly  being  introduced  from 
India  by  Malabar  coolies.  The  disease  is  increasing. 
There  were  1,609  admissions  in  all  hospitals,  with 
257  deaths.  The  danger  of  the  disease  to  life  is  in  the 
profound  anemia,  which  so  lowers  the  vitality  that  the 
victim  is  carried  off  by  any  insignificant  intercurrent 
affection. 

Plague. — The  Plague  Committee  is  a  standing  com- 
mittee, including  besides  the  principal  civil  medical  of- 
ficer, the  collector  of  customs  of  the  ports,  the  govern- 
ment agent  and  the  mayor  of  Colombo.  Eegular  meet- 
ings are  held  and  precautions  instituted  to  combat  an 
outbreak  of  the  disease.  All  returns  of  plague  from  in- 
fected ports  are  received  by  the  committee;  telegraph 
accounts  of  plague  occurring  in  places  adjacent  to  Cey- 
lon are  received  regularly.  It  is  to  the  eternal  watch- 
fulness of  this  committee  and  the  prompt  action  of 
the  staff  of  port  surgeon?  that  is  due  the  freedom  of 
the  island  from  this  x\siatic  disease.  Galle  continues 
to  be  the  plague  port ;  only  one  case  of  this  disease  was 
reported  from  the  harbor  of  Colombo  during  the  year. 
The  patient  contracted  the  disease  at  Hongkong  and 
was  landed  and  isolated  at  Galle,  and  the  contacts  for 
this  port  were  placed  in  quarantine.  The  patient  re- 
covered. Eat  destruction  was  carried  out  at  the  cus- 
toms premises  and  by  the  municipalities  of  Colombo 
and  Galle. 


184  AROUND    THE    WORLD   VIA    INDIA. 

Syphilis. — Colombo,  Kandy  and  Galle  are  provided 
with  a  special  hospital  for  the  treatment  of  women 
suffering  from  venereal  diseases.  The  total  number  of 
new  cases  admitted  was  351  which,  with  30  remaining 
from  the  previous  year,  makes  a  total  of  371.  Of  the 
371  women  treated  in  these  hospitals  27  were  affected 
with  primary  syphilis,  G8  secondary,  62  tertiary,  4 
hereditary,  156  gonorrhea  and  54  unclassified  syphi- 
litic lesions. 

Parangi. — The  hospital  records  show  that  this  dis- 
ease has  steadily  increased  during  the  last  five  years. 
The  death  rate  is  remarkably  small;  out  of  3,434  ad- 
missions for  this  disease  during  the  year  there  were 
only  10  deaths. 

Vaccination. — Vaccination  is  carried  out  vigorously 
in  the  island,  as  is  shown  by  the  Eeport  on  Sanitation. 
During  the  year  149,901  subjects  were  vaccinated;  of 
this  number  7,760  were  revaccinations. 

Lack  of  Seiverage. — In  Colombo,  Kandy  and  Galle 
the  fecal  matter  is  removed  at  night  and  buried.  In 
Colombo  the  experiment  was  made  of  using  the  con- 
tents of  the  cesspits  as  a  fertilizer,  but  it  proved  unde- 
sirable and  was  abandoned  as  a  failure.  What  these 
cities  need  is  a  system  of  sewerage,  as  they  all  have  an 
excellent  location  to  carry  out  such  a  plan  with  suc- 
cess. 

SOTSA    BACTERIOLOGIC    INSTITUTE,    COLOMBO. 

Since  its  opening  this  institution  has  undertaken 
work  of  diverse  character,  and  is  now  supplying  a  long- 
felt  want  in  the  colony  by  its  researches  in  bacteriologic 
analyses  of  tissues,  secretions,  blood,  etc.,  so  indis- 
pensable to  scientific  diagnosis  of  diseases.  The  act- 
ing director.  Dr.  S.  C.  Paul,  F.E.C.S..  is  consulted  by 
government  medical  officers  and  private  practitioners 
for  reports  on  specimens  submitted  to  him  on  bacterio- 
logic and  allied  subjects. 


CEYLON.  185 

CITY    OF    COLOMBO. 

The  city  of  Colombo  is  au  important  port  and  the 
largest  city  in  the  island.  It  has  a  very  mixed  popula- 
tion of  128.000.  More  Europeans  live  here  than  any- 
where else  in  Ceylon.  The  steamers  anchor  some  dis- 
tance from  the  wharf.  It  has  excellent  streets,  the  so- 
called  red  streets,  a  bright  red  from  the  color  of  the 
soil,  electric  lighting  and  electric  tramways.  The  Grand 
Oriental  Hotel,  near  the  wharf,  is  the  best  hostelry  in 
the  island.  Every  room  has  an  electric  fan — a  great 
comfort  to  the  traveler  throughout  the  entire  year.  The 
rooms  of  the  hotel  are  never  locked,  as  stealing  and 
robbery  are  almost  unknown.  The  crowd  of  chamber- 
men  and  servants  are  always  ready  to  wait  on  the  guests 
and  understand  to  perfection  the  system  of  exacting 
a  substantial  tip.  At  present  writing  the  temperature 
in  my  room,  in  spite  of  the  faithful  fan,  registers  91 
F.  The  air  is  thoroughly  saturated  with  moisture, 
which  is  accountable  for  the  oppressive  sensation  of 
heat  that  every  newcomer  experiences. 

The  Cinnamon  Gardens  is  the  city  park  and  is  a 
lovelv  place.  The  drives  along  the  coast  are  beautiful 
and  disclose  at  every  turn  the  luxurious  vegetation  of 
this  wonderful  island.  The  native  policemen  are  cour- 
teous and  devoted  to  their  duties.  They  are  fully  im- 
pressed with  the  responsibility  and  dignity  of  their  of- 
fice, and  cross  and  recross  their  beats  with  a  keen  eye 
for  any  evildoers.  The  city  has  a  museum,  free  library 
and  many  charitable  institutions  for  the  sick  and  poor. 

THE  GENERAL  CIVIL  HOSPITAL. 

The  hospital  is  made  up  of  numerous  one-story  brick- 
and-mortar  pavilions  connected  by  roofed  colonnade, 
cemented  walks  which  impart  to  the  whole  complex  of 
buildings  a  fine  architectural  appearance.  The  snow- 
white  walls  and  pillars  and  the  red  tile  roofs  are  in 
strong  and  beautiful  contrast  with  the  perennial  green 
surrounding  the   building   inside   and   outside   of   the 


18t>  AKOUND  THE   WOULD  VIA  INDIA. 

large  tquare  court  wliieli  they  inclose.  The  income 
from  pay  patients  is  not  large,  but  the  government  ap- 
propriations are  liberal.  All  of  the  employes  are  sal- 
aried, including  physicians,  internes  and  nurses.  Dr. 
Thomasz,  one  of  the  two  attending  surgeons,  receives 
4,000  rupees  a  year.  He  conducted  me  through  the  dif- 
ferent wards  and  showed  me  many  interesting  surgical 
and  medical  cases.  The  nursing  is  in  care  of  thirteen 
Anglican  sisters  and  a  number  of  women  nurses,  grad- 
uates from  the  Lady  Havelock  Hospital.  A  corps  of 
native  men  and  women  act  as  helpers.  The  wards  are 
airy,  well  lighted  and  furnished  plainly  but  comfortably. 

Echinococcus,  so  common  in  Australia,  is  not  seen 
here;  on  the  other  hand,  elephantiasis  is  quite  common. 
Dr.  Thomasz  has  operated  on  a  number  of  cases  of 
scrotal  elephantiasis  with  success.  The  natives  are 
not  very  good  subjects  for  prolonged  major  operations, 
as  they  are  very  liable  to  inordinate  shock.  Chloroform 
is  used  as  a  general  anesthetic,  and  in  several  thousand 
anesthesias  only  two  deaths  occurred.  The  operating 
room  is  old  and  not  up  to  modern  requirements.  The 
equipments  and  appliances  also  leave  much  to  be  de- 
sired. Asepsis  has  not  succeeded  here  as  well  as  could 
be  desired  and  the  many  failures  to  obtain  primary 
wound  healing  having  finally  led  to  the  abandonment  of 
buried  absorbable  sutures  of  any  kind.  Silk  is  used 
almost  exclusively  and  the  sutures  are  removed  from 
three  to  seven  days  after  the  operation.  The  same  prac- 
tice is  followed  in  the  Kandy  General  Hospital.  In  the 
outdoor  department  I  watched  an  interne  dress  two 
recent  wounds.  He  did  not  remove  his  coat,  and  a 
basin  with  some  antiseptic  solution  was  relied  on  in 
performing  primary  disinfection.  Not  much  time  or 
effort  was  expended  in  preparing  the  wounds  for  su- 
turing, and  I  have  little  doubt  that  the  sutures  rather 
retarded  than  assisted  Nature's  efforts  in  repairing  the 
wound. 

Ovarian  tumors  arc  quite  common,  but  mvofibroma 


CEYLON.  187 

is  rare  among  the  native  women.  Women  the  subjects 
of  ovarian  cysts  of  enormous  size  frequently  enter  this 
hospital  for  operation.  Little  operating  is  done  in 
the  country  villages  and  patients  usually  do  not  sock 
medical  advice  until  they  are  much  inconvenienced 
from  the  size  of  the  tumor.  Prostatectomy  is  performed 
by  the  suprapubic  route.  Stone  in  the  bladder  is  not 
of  frequent  occurrence.  Tuberculosis  of  the  lungs  is 
quite  common,  as  during  one  year,  1901-1902,  956  cases 
Avere  admitted  to  the  different  hospitals.  Surgical  tu- 
berculosis is  much  less  prevalent,  as  during  the  same 
year  only  60  cases  of  tuberculosis  of  the  glands  of  the 
neck  were  treated,  33  of  lupus  and  only  5  cases  of  tuber- 
culosis of  the  joints.  I  did  not  see  a  single  case  of  spinal 
deformity  among  the  thousands  of  people  I  saw  in 
Ceylon  and  only  one  case  of  ankylosis  of  the  hip  and 
2  cases  of  ankylosis  of  the  knee  joint,  and  very  few 
cases  of  tuberculosis  of  glands  of  the  neck  or  its  re- 
mote result,  scarring  of  the  neck.  Only  12  cases  of 
-snakebite  are  reported  for  one  year,  of  whom  2  died. 

SEPTIC    THROMBOPHLEBITIS    OF    THE    SPERMATIC    VEINS. 

Dr.  Thomasz  a  few  years  ago  described  a  form  of 
septic  thrombophlebitis  occurring  in  young  men  the 
subject  of  varicocele;  the  immediate  cause  is  usually 
an  injury  of  some  kind  which  induces  the  thrombosis. 
When  this  has  taken  place  the  pus  microbes  find  in  the 
obliterated  lumen  of  the  veins  a  favorable  soil  for  their 
reproduction,  which  leads  very  rapidly  to  pyemia  and 
death.  The  disease  pursues  a  very  acute  course  and  is 
nearly  always  fatal  unless  an  early  radical  operation 
is  performed,  which  must  also  include  the  testicle  on  the 
affected  side. 

CEYLON   MEDICAL    COLLEGE. 

The  Ceylon  Medical  College  was  formally  opened  on 
June  1,  1870,  with  one  principal  and  three  lecturers. 
The  first  intent  of  the  school  was  to  be  "simply  an  ele- 
mentary school."    The  faculty  was  increased  three  years 


188  AHOLXD    TJIE    WOULD    VIA    INDIA. 

later  and  in  1888  it  became  a  regular  medical  college 
with  power  to  license  in  medicine  and  surgery.  Lady 
students  were  admitted  to  the  college  for  the  first  time 
on  May  5,  1892.  The  one-story  building  of  the  col- 
lege, with  library,  lecture  rooms  and  laboratories,  was 
erected  at  the  expense  of  the  late  Susew  de  Soysa.  The 
dissecting  room  is  a  separate  building,  as  well  as  the 
laboratory  for  physiologic  and  pathologic  chemistry. 
The  clinics  are  given  in  the  General  Civil  Hospital,  op- 
posite the  college  building.  The  course  of  study  em- 
braces five  years.  The  teaching  force  consists  of  32 
professors,  lecturers,  demonstrators  and  assistants.  T. 
F.  Garvin,  M.B.,  CM.,  Aberdeen,  is  a  lecturer  on  sur- 
gery, and  H.  G.  Thomasz  is  clinical  lecturer.  Physics, 
biology  and  elementary  zoology'  are  included  in  the  pri- 
mary branches.  All  the  specialties  are  included  in  the 
faculty.  The  present  attendance  of  students  is  about 
120.  The  students  are  given  ample  opportunity  to  serve 
in  the  hospital  as  dispensers  and  dressers,  and  the 
clinical  material  for  instruction  is  very  large,  including 
practical  obstetrics  in  the  De  Soysa  Lying-in  Hospital. 
The  school  has  also  a  department  for  apothecaries.  The 
standards  for  admission  and  graduation  correspond 
with  those  of  the  medical  schools  of  the  United  King- 
dom. The  fee  for  the  whole  course  in  advance  (to  be 
paid  in  one  sum  at  the  commencement  of  the  first  col- 
lege year),  is  800  rupees  ($256).  A  number  of  prizes 
and  medals  have  been  established  by  friends  of  the  in- 
stitution. At  the  close  of  the  session  1901-1902,  the 
school  graduated  26,  the  following  year  only  9  candi- 
dates. Part  of  the  entrance  and  professional  examina- 
tions are  conducted  in  the  Tamil  and  Singhalese  lan- 
guages, of  which  the  student  must  have  a  fair  Icnowl- 
edge. 

LEPER    ASYLUM    AT    HENDALA. 

I  visited  this  institution,  which  by  the  carriage  drive 
is   ton   miles   distant   from   Colombo.     The  road  leads 


CKVI.ON. 


189 


througli  ii  x'rics  of  native  villa;j,c>.  rice  Ik'Ids,  marshes 
and  strips  oT  })iiiii('val  forests  and  dense  jungles.  The 
colony  is  located  on  seventeen  acres  of  land  enclosed  by 
a  stone  Avail.  The  nnnierons  one-story  buildings  of 
britk  and  mortar  are  connected  by  roofed  cement,  walks. 
The  entire  settlement,  exclusive  of  physicians,  numbers 
360,  of  whom  there  are  only  G9  women.  The  young- 
est patient  is  only  (>  yeaiv  old.  One  of  tlu^  patients,  a 
man  (50  years  of  age,  has  lieen  here  for  thirty  years. 
He  is  atflicted  with  the  anesthetic  form  of  the  disease, 


Fi.£ 


-Leper    Asylum    at    Heudala. 


is  totally  blind  and  has  lost  all  of  his  lingers  and  toes. 
The  disease  has  cured  itself,  but  has  left  the  patient  a 
helpless,  shapeless  mass  of  flesh.  .It  appears  that  the 
anesthetic  and  tubercular  forms  of  the  disease  occur 
about  with  the  same  frequency.  The  institution  is 
well  managed  and  the  nurses  and  two  resident  physi- 
sicians  do  all  in  their  power  to  render  the  existence  of 
these  hopelessly  diseased  victims  as  comfortable  as  pos- 
sible. The  patients  appeared  to  be  content  with  their 
fate  and  the  humane  restraint  that  is  practiced.     The 


190  AltOUXD    THE    WORLD    VIA    INDIA. 

law  of  segregation  came  recently  in  force,  but  the  au- 
thorities find  it  difficult  to  carry  it  out  with  the  strict- 
ness for  which  it  is  intended. 

LEPER  BUDDHIST  CELEBRATION. 

The  day  I  visited  the  asylum  was  the  annual  celebra- 
tion to  the  memory  of  Buddha.  It  was  a  gala  day,  the 
walk  leading  from  the  entrance  to  the  little  Buddhist 
temple  was  decorated  with  palm  leaves.  The  proces- 
sion was  formed  outside  of  the  gate.  There  was  no 
elephant  to  draw  the  shrine  of  Buddha  perched  on  a 
rude  cart,  but  a  little  humpbacked  bullock  answered 
the  purpose  very  well,  and  he  performed  his  part  of  the 
celebration  with  credit  to  his  kind.  A  brass  band  with 
native  instruments  headed  the  procession,  then  came 
the  shrine  followed  by  a  number  of  bronze-colored  yel- 
low-robed priests,  and  lastly  the  Buddhist  lepers  in  all 
stages  of  the  disease.  Explosives  were  thrown  against 
the  stone  wall,  where  they  exploded  with  a  terrible  re- 
port, emitting  at  the  same  time  a  blue-black  smoke 
which  enveloped  the  slowly  moving  procession.  The 
bombardment,  with  the  ear-splitting  music  of  the  native 
band,  imparted  to  the  whole  affair  a  weird  appearance. 
When  the  procession  entered  the  temple  silence  was 
restored,  and  only  the  murmurings  of  the  priests  could 
be  heard  outside  of  its  sacred  walls. 

CITY   OF    KANDY. 

This  little  city  of  20,000  inhabitants,  the  former  resi- 
dence place  of  the  kings  of  Ceylon,  has  degenerated 
into  a  dilapidated  mountain  village.  It  is  located  in 
a  valley  in  the  subalpine  region,  surrounded  by  verdant 
hills  and  nestled  around  a  little  artificial  lake  of  the 
same  name.  It  is  accessible  from  Colombo  by  rail, 
the  road  passing  the  first  fifty  miles  through  rice  fields, 
marshes,  then  ascending  for  thirteen  miles  in  a  zigzag 
line  to  the  height  of  1,600  feet  above  the  level  of  the 
sea,  and  then  through  a  valley  nine  miles  in  length, 


Fig.    0(1. — Tootli    of    Budflha. 


C'KYl.OX.  1!);5 

when  the  little  city  siiddonly  eoiiies  into  view.  The 
beauty  of  Kandy  and  its  environments  have  been  greatly 
exaggerated  by  sentimental  writers.  The  town  is  noted 
for  the  Temple  of  the  Tooth,  an  old,  crumbling  pile 
of  stones  which  contains  in  its  most  interior  and  not 
accessible  part  a  tooth  of  the  famous  prophet.  (Fig. 
36).  I  happened  to  be  in  the  city  on  the  day  when  the 
Buddhists  turn  out  in  masses  to  do  honor  and  homage 
to  their  deity — Buddha. 

THE  ANNUAL  BUDDHA  CELEBRATION. 

For  three  days  the  little  city  was  packed  with  a  seeth- 
ing mass  of  humanity.  In  many  places  standing  room 
was  scarce.  The  great  event  took  place  at  9  o'clock 
Saturday  evening,  August  27.  The  procession,  headed 
by  a  band  of  native  musicians  and  three  elephants  abreast 
with  their  riders,  was  made  up  of  "36  other  ele- 
phants, an  army  of  chiefs  gorgeously  arrayed,  and  bare- 
headed yellow-gowned  priests,  dancers  with  faces  dis- 
figured by  white  stripes,  screaming  and  yelling  boys  and 
the  faithful  followers  of  the  god  of  whom  at  least  one 
tooth  had  remained  to  testify  that  he  once  inhabited 
this  earth ;  the  tooth  that  was  carried  in  the  proces- 
sion in  a  shrine  carefully  guarded.  The  most  solemn 
celebrants  were  the  29  magnificent  elephants,  who 
marched  with  slow,  thoughful  steps,  their  sly  little  eyes 
peeping  through  small  holes  in  their  masks  of  royal 
red,  casting  a  glance  now  and  then  on  the  sea  of  hu- 
manity on  either  side  of  the  road.  The  great  mass  of 
people  who  took  an  active  part  in  this  celebration  and 
the  enthusiasm  aroused  when  the  hiding  place  of  the 
tooth  of  Buddha  came  into  view  showed  only  too  clear- 
ly that  this  deity  has  not  lost  his  influence  and  power 
among  the  natives  of  Ceylon. 

BOTANICAL  GARDEN. 

The  botanical  garden  four  miles  from  Kandy  is  the 
most  interesting  spot  in  this  part  of  the  subalpine  region  - 


194  AliOL'ND    THE    WORLD    VIA    INDIA. 

of  Ceylon.  It  comprises  thirteen  acres  of  land,  included 
in  a  horseshoe  bend  of  the  jMahaweli  ganga.  Every 
known  variety  of  palm  can  be  found  here,  as  well  as 
specimens  of  nearly  all  trees  and  shrubs  of  the  tropics. 
I  saw  here  a  clove  tree  (Eugenia  caryopliylata)  at  least 
forty  feet  high,  an  ebony  tree  (Diospyros  ehenum)  and 
a  nux  vomica  tree  of  about  the  same  dimensions.  The 
towering  palms,  the  dark  walks  cut  through  the  other- 
wise impenetrable  jungles,  and  the  gorgeous  flowers, 
of  trees,  shrubs  and  plants,  make  this  spot  a  real  para- 
dise on  earth,  a  great  contrast  to  the  dilapidated  city 
of  Kandy. 

KAXDY  GEXERAL   CIVIL   HOSPITAL. 

This  is  a  very  pretty,  comfortable,  clean,  well-man- 
aged, general  hospital,  built  on  the  same  plan  as  the  Co- 
lombo General  Hospital.  It  is  located  outside  of  the 
depressing  influences  of  a  formerly  famous,  now  crumb- 
ling city,  in  a  little  vale  surrounded  by  green  hills  on 
all  sides.  The  snow-white  one-story  pavilions  and  the 
connecting,  roofed  cement  walks  lined  with  square 
columns  of  the  same  color,  around  a  central  square  or- 
namented with  jack  and  lio-trees.  palms  and  flower- 
beds, give  it  the  very  picture  of  isolation,  comfort  and 
peace.  The  243  patients  inside  of  its  walls  enjoyed 
the  blessings  of  careful  nursing  and  the  henefits  of  ex- 
cellent surgical  and  medical  skill. 

Dr.  James  William  de  Hoedt  is  the  physician  and  sur- 
geon in  charge,  ably  assisted  by  a  woman  house  sur- 
geon, Miss  Winifred  Nell.  L.E.C.P.  and  S.E.  Dr. 
Nell  is  not  only  a  very  competent  physician,  but  at 
the  same  time  a  skilled  naturalist,  as  I  had  an  oppor- 
tunity to  learn  during  the  visit  we  made  together  to  the 
botanical  garden.  The  nursing  staif  is  in  charge  of  an 
Anglican  sister.  Sister  Eustacia  Mary,  a  well-trained 
nurse  and  charming  lady.  I  found  here  a  number  of  in- 
teresting emergency  cases  and  the  usual  predominance 
of  ankvlostoma.  malaria  and  enteric  fever.     There  have 


CEYLON.  195 

occurred  here  in  the  small  maternity  ward  recently  five 
cases  of  puerperal  tetanus,  in  all  of  which  recovery  took 
place.  This  liospital  has  a  remarkable  record  in  the 
treatment  of  tetanus,  13  cases  without  a  death.  Buried 
sutures  are  not  ('m[)loye(l.  silk  is  used  exclusively  and 
the  sutures  are  always  remoxed.  Chloroform  is  the  fa- 
vorite anesthetic  and  biniodid  of  mercury  is  largely  re- 
lied on  in  hand  and  surface  disinfcc-tion. 
Madras,  India,  Aug.  30,  1904. 


INDIA. 

MADRAS    MEDICAL    COLLEGE   AXD    GOVEItNMEXT    GENERAL 
HOSPITAL. 


India,  with  its  300,000.000  inhabitants,  has  only  four 
medical  colleges,  located  at  Madras,  Calcutta,  Lahore 
and  Bombay.  All  of  these  medical  schools  are  in  affil- 
iation with  the  respective  universities.  On  recommenda- 
tion of  the  medical  facilities,  the  universities  confer  the 
degrees,  but  the  medical  schools  receive  no  financial  aid 
from  the  universities  and  set  their  own  standards  of 
requirements  for  admission  and  graduation.  All  the 
medical  schools  are  patterned  after  those  of  the  United 
Kingdom  as  to  requirements  for  admission,  graduation 
and  methods  of  teaching.  From  information  obtained 
from  different  sources  I  find  that  the  great  stumbling 
block  of  the  Indian  medical  student  is  language.  A 
knowledge  of  Latin  is  a  rara  avis  and  tihe  meaning  of 
ordinary  English  words  is  hard  for  them  to  express 
and  comprehend.  The  teachers  find  this  imperfect 
knowledge  of  the  English  language  the  greatest  drawback 
in  ingrafting  their  ideas  into  the  minds  of  the  students. 
The  number  of  medical  students  in  the  different  in- 
stitutions at  the  present  time  is  about  2,000.  Very  few. 
Mohammedans  study  medicine;  the  great  majority  of 
students  are  Hindus  and  Parsees.  The  Hindus  are  said 
to  be  the  brightest  students.  The  classes  have  increased 
in  size  very  rapidly  during  the  last  few  years,  so  rapidly, 
indeed,  that  space  and  equipment  in  all  of  the  schools 
have  become  entirely  inadequate.  From  what  I  have 
seen  of  the  students  in  the  different  medical  colleges  I 
have  become  impressed  with  their  lively,  cheerful  dis- 
positions and  their  earnest  devotion  to  their  work.   The 


198 


AKOUXD    THE    WOELD    VIA    INDIA. 


teaching  force,  as  a  rule,  is  inadequate  in  number  in  all 
the  schools,  and  in  consequence  the  men  are  over- 
worked. I  will  give  only  one  striking  instance  of  this 
kind.  Lieutenant-Colonel  Dimmock  of  Bombay  is  di- 
rector of  the  Jamsetjee-Jeejeebhoy  Hospital,  principal 
of  Grant  Medical  College,  and  professor  of  obstetrics, 
gynecology  and  diseases  of  children.  Enough  work  for 
five  men  under  ordinary  circumstances.     The  men  of 


Fig.  37. ^Madras  Medical  College  and  (Government  General  Hos- 
pital. 

the  Indian  medical  service  who  are  engaged  in  medical 
teaching  are  overworked  and  underpaid,  and  they  are 
the  men  who  do  more  for  India  than  any  other  class  of 
men. 

MADRAS    MEDICAL    COLLEGE. 

The  Madras  Medical  College  was  originally  estab- 
lished as  a  medical  school  in  1835  (Fig.  37).  The 
classes  received  their  instruction  at  first  in  rooms  ad- 
joining the  quarters  of  the  surgeon  general  of  the  gen- 
eral hospital.  The  main  building  of  the  school  was 
opened  in  1836  and  then  consisted  of  four  apartments — 


INDIA. 


199 


a  theater  or  lectiii'c  lomii.  a  lilirarv,  a  iiiu-euiii  and  a 
laboratory.  'I'lie  school  eoiiiineneed  with  a  teaching 
force  of  seven.  10  medical  apprentices  and  11  native 
medical  pupils.  Private  students  were  first  admitted 
in  1838.  They  obtained,  in  common  with  government 
students,  a  free  education.  In  1851  it  became  a  college, 
and  in  1857  it  was  placed,  in  the  list  of  affiliated  insti- 
tutions. The  buildings  were  altered  and  enlarged  in 
1867.  In  1885  separate  anatomic  buildings  were  erected, 
to  which  were  added  a  theater  with  a  dissecting  room 


Fig.   38. — Another   view   of  ^r.arlras   Medical   College  and   Govern- 
ment   General    Hospital. 

for  the  pupils  of  the  hospital  assistant  department  and 
a  museum  in  1887-88  (Fig.  38).  Separate  buildings 
for  biologic  and  hygienic  laboratories  followed.  In 
1875  the  college  admitted  on  its  mils  three  new  classes 
of  students — viz.,  candidates  for  the  degree  of  licenti- 
ates in  medicine  and  surgery,  for  the  new  grade  of  civil 
apothecary,  and  female  students.  The  system  of  free 
education  for  the  students  of  the  college  department  was 
abolished  a  year  before  this  department  had  been  closed, 
in  order  to  allow  the  professors  to  devote  themselves 
to  the  teaching  of  subordinates  for  the  service  of  the 


200  AltOUND    THE    WOliLD    VIA    INDIA. 

government.  For  the  second  time  the  hospital  assistant 
department  was  transferred  to  the  auxiliary  medical 
school  at  Eayapuram  in  1903.  The  principal  of  the 
college  at  the  present  time  is  Lieut.-Col.  J.  Maitland, 
M.D..  I.M.S.,  F.M.U.  The  teaching  stafE  consists  of 
23  professors  and  assistant  professors,  and  the  numher 
of  students  is  400.  Major  G.  G.  Giffard,  I.M.S.,  is  pro- 
fessor of  surgery,  and  Miss  V.  Adams,  M.B..  lecturer 
in  midwifery  to  female  students.  The  calendar  of  the 
college  for  1904-1905  contains  the  following  regula- 
tions : 

DEESS — FOR    NATIVES    ONLY, 

1.  The  typical  dress:  Turhan.  a  long  or  short  coat 
buttoned  up  to  the  neck,  trousers,  socks  and  English 
shoes.  Underclothing  according  to  choice,  but  where 
the  material  of  the  coat  is  not  washable,  e.  g.,  tweed,  a 
linen  collar  should  be  worn,  and,  if  the  coat  does  not 
button  up  to  the  neck,  collar  and  tie  must  alwa3^s  be 
worn,  whatever  the  material.  The  Parsee  hat  and  Bur- 
man  head  cloth  are,  for  the  purposes  of  these  regula- 
tions, to  be  regarded  as  turbans. 

2.  ^Modifications  permissible:  (a)  Students  who 
wear  a  "tuft"  or  who  shave  the  scalp  must  wear  a  tur-; 
ban  which  must  conceal  the  tuft  when  it  is  present, 
(b)  Students  who  dress  their  hair  after  the  European 
fashion  may  wear  caps,  but  indoors,  if  their  dress  is 
otherwise  European,  the  cap  must  be  removed,  (c)  A 
cap  when  worn  must  be  black  and  may  have  a  lace  bor- 
der, but  not  otherwise  decorated — and  no  caps  are  al- 
lowed to  be  worn  on  ceremonial  occasions,  such  as  prize 
distribution,  etc.  Mohammedans  may  be  allowed  to 
wear  the  fez  on  ordinary  occasions,  but  not  at  cere- 
monial observances.  (d)  Any  student  may  wear  a 
dhote  or  mundu;  he  must  then  go  barefooted  indoors 
or  wear  socks  and  European  shoes.  .  The  latter  are  rec- 
ommended, as  the  feet  are  apt  to  get  soiled  or  Inocu- 


INDIA.  !^01 

latcd  with  septic  matter  either  in  the  hos})ital  wards, 
dissecting  rooms  or  out-patient  rooms. 

3.  All  articles  of  dress,  whatever  the  material,  must 
be  clean. 

This  dress  regulation  must  certainly  interest  our 
American  students,  as  even  with  these  restrictions  the 
sight  of  a  class  of  students  of  the  medical  colleges  of 
India  is  a  very  much  checkered  and  picturesque  one, 
probably  made  up  of  more  colors  than  the  checkered 
coat  of  Joseph.  The  candidates  for  the  M.B.  and  CM. 
section  must  have  passed  the  first  examination  in  arts 
of  tliis  university,  or  an  examination  accepted  by  the 
syndicate  as  equivalent  thereto.  The  course  of  training 
for  this  class  extends  over  five  years,  and  the  fees 
charged  for  tuition  are: 

Rupees. 

For  the  first  year  of  study 100  ($32.00) 

For  the  second  year  of  study 155  (   49.60) 

For  the  third  year  of  study 155         (   49.60) 

For  the  fourth  year  of  study 100  (   32.00) 

For  the  final  year  of  study 100  (   32.00) 

Or  if  paid  in  one  sum  on  joining  college,  .500  rupees, 
equivalent  to  about  $160. 

The  course  for  the  L.M.  and  S.  degree  extends  over 
four  years  and  the  fees  charged  for  the  whole  course  if 
paid  in  advance  amount  to  470  rupees  ($150).  The 
candidates  for  these  degrees  are  obliged  to  pass  only 
three  examinations.  The  first  examination  includes 
one  course  in  each  of  the  following  branches :  An- 
atomy, physiology,  chemistry,  practical  chemistry,  prac- 
tical pharmacy,  histology.  The  second  includes  one 
course  in  medicine,  surgery,  materia  medica  and  thera- 
peutics, general  pathology,  practical  pathology  and  bac- 
teriology, hygiene,  practical  hygiene,  medical  jurispru- 
dence, minor  surgery.  The  third  and  final  examination 
includes  midwifery  and  diseases  special  to  women  and 
the  newborn  child,  ophthalmolog};.  mental  diseases  and 
operative  surgery.  The  examination  test  for  the  degree 
of  ]\I.B.  and  CM.  is  much  more  severe.     Provision  is 


202  AROUXD    THE    AVORLD   VIA    IXDIA. 

made  for  the  education  of  military  pupils  for  the  Indian 
subordinate  medical  department,  colonial  apprentices, 
apothecaries,  male  and  female,  and  chemists  and  drug- 
gists. As  an  inducement  for  diligence  on  the  part  of 
the  students  the  Madras  Medical  College  offers  annually 
nine  medals,  eleven  prizes  and  ten  scholarships. 

MADRAS  GOVERNMEXT  GENERAL  HOSPITAL. 

This  institution  is  intimately  connected  with,  and  in 
fact  is,  the  clinical  part  of  the  Madras  Medical  College 
(Fig.  37),  all  of  the  attending  physicians  and  surgeons 
being  members  of  its  faculty.  The  hospital  is  made  up 
,  of  a  number  of  two-story  pavilion  buildings  around  a 
capacious  square  court  ornamented  with  tropic  trees, 
shrubs  and  flowers.  The  buildings  harmonize  with  each 
other.  It  can  accommodate  450  patients.  The  amoimt 
and  variety  of  clinical  material  in  this  institution  is 
simply  enormous.  The  operating  theater,  while  not  up 
to  all  of  the  modern  requirements,  is  one  of  the  best  in 
India.  Chloroform  is  the  routine  anesthetic.  The  fa- 
vorite suturing  material  is  silk  and  silkworm  gut,  as  the 
use  of  absorbable  sutures  has  given  rise  to  many  disap- 
pointments. Biniodid  of  mercury  is  tlie  favorite  anti- 
septic for  hand  and  surface  disinfection  and  sterilized 
gauze  is  used  for  dressing  wounds.  I  found  a  great 
many  emergency  cases  in  this  hospital,  fractures  and 
accidental  wounds,  as  well  as  a  number  of  cases  of  ab- 
scess of  the  liver  recently  operated  on.  Among  the 
most  important  cases  was  a  man  who  was  admitted  into 
the  hospital  a  few  days  previously  with  a  strangulated 
inguinal  hernia  of  four  days'  standing.  Professor  Gif- 
fard  performed  the  operation.  The  bowel  was  gan- 
grenous. Enterectomy  was  done,  the  continuity  of  the 
bowel  restored  by  suturing,  and  the  patient  is  recovering 
without  having  shown  any  untoward  symptoms  since 
the  operation.  Although  inguinal  hernia  is  met  with 
quite  frequently  in  Madras,  femoral  hernia  is  very  rare, 
only  one  case  being  admitted  to  the  hospital  during  the 


Fig.    :?0. — Chondrosarcoma   of   luiraeriis   and   scapula.      Successful 
interscapular  ampntatioa  performed  by  Captain  Niblock,  I.  M.  S.  of 
Madras. 


INDIA.  205 

past  20  years.  (CifTiinl.)  FJcpliantiasis  of  the  scro- 
tum is  very  frequently  operated  on  in  this  hospital. 
Lient.-Col.  ]\raithnid  lias  performed  this  operation  IGO 
times  with  most  excellent  immediate  and  remote  results. 
Stone  in  the  bladder  is  very  common  in  this  part  of 
India.  Crushing  is  the  favorite  operative  procedure. 
Many  surgeons,  among  them  Professor  Giffard,  prefer 
to  perform  the  operation  through  a  median  perineal 
incision  instead  of  the  lateral,  and  in  case  the  stone  is 
too  large  to  be  removed  by  this  method  it  is  extracted 
whole  or  in  fragments  through  a  suprapul)ic  incision. 

CARCINOMA   IN   INDIA. 

An  unusual  number  of  cases  of  cancer  of  the  mouth 
find  their  way  into  this  hospital  and  its  frequency  is 
attributed  by  the  surgeons  to  betel  chewing.  Two 
pathologic  forms  are  distinguished,  the  papillomatous 
and  ulcerative,  the  latter  being  much  more  malignant 
and  pursuing  a  very  acute  course.  Capt.  W.  J.  Niblock, 
I.M.S.,  surgeon  Government  Hospital,  has  contributed 
a  very  important  article  to  the  literature  of  "Cancer  in 
India,"  published  in  the  Indian  Medical  Gazette.  May, 
1902.  The  paper  is  based  on  the  clinical  records  of  this 
hospital.  He  has  the  following  to  say  regarding  betel 
chewing  as  a  cause  of  carcinoma  of  the  cheeks  and  jaws : 
"On  looking  at  Table  lA,  one  can  not  avoid  being  struck 
very  forcibly  by  the  enormous  number  of  patients 
shown  as  admitted  for  carcinoma  of  the  cheek  and 
jaws.  Carcinoma  of  the  cheek  alone  accounts  for  al- 
most one-third,  and  carcinoma  of  the  cheek,  jaws  and 
tongue  taken  together  for  more  than  one-half  of  the 
total  admissions  of  carcinoma  cases.  The  cheek 
is  the  part  most  commonly  aifected  in  Hindus 
and  Mohammedans,  males  and  females.  The  dis- 
ease affects  the  buccal  surface  of  the  cheek,  gen- 
erally commencing  ojiposite  the  teeth  of  the 
lower  jaw  and  spreading  with  varying  rapidity.  The 
frequency  of  carcinoma  in  this  situation,  in  my  opin- 


206  AROUXD    THE    WORLD    VIA    IKDIA. 

ion.  due  to  the  chewino-  of  ^betel/  a  common  habit  in 
this  conntrv,  and  indulged  in,  I  believe,  by  almost  all 
classes  of  natives.  'Betel.'  as  used  in  the  Madras  presi- 
dency, is  said  to  be  made  up  of  the  following  parts : 
(a)  The  essential  constituents,  viz.,  'betel'  leaf,  areca 
nut,  and  caustic  lime  (chunam).  (b)  Condiments, 
such  as  cloves,  nutmeg,  cardamons,  cul^ebs.  Dry  ]iow- 
dered  cocoanut  and  oil  are  also  sometimes  added.  The 
above  components  are  mixed  in  varying  proportions, 
rolled  up  in  a  betel  leaf,  and  placed  in  the  mouth.  They 
are  then  chewed  and'  rolled  about  by  the  tongue  and 
cheek  for  a  period  varying  from  10  to  30  minutes  and 
then  spat  out." 

I  can  testify  from  observation  to  the  imiversal  use  of 
betel  both  in  India  and  Ceylon.  Carcinoma  of  other 
parts  of  the  body  appears  to  be  more  rare  than  in  our 
country.  The  tables  of  Capt.  Niblock  show,  for  in- 
stance, that  513  cases  of  carcinoma  of  the  mouth  were 
admitted  to  the  General  Hospital  during  10  years, 
1892-1901,  and  only  -14  cases  of  carcinoma  of  the  breast 
and  19  of  the  lip.  Concerning  the  latter  he  says: 
"Epithelioma  of  the  lip,  it  will  be  noted,  is  com- 
paratively rare,  and.  so  far  as  my  experience  goes,  af- 
fects both  lips  with  equal  frequency.  The  rarity  of 
carcinoma  in  this  situation  is  no  doubt  explainable  by 
the  fact  that  smoking  from  a  pipe  (or  at  any  rate  a 
clay  pipe)  is  not  indulged  in  by  the  natives  of  this  coun- 
try.'" The  comparative  frequency  of  carcinoma  of  the 
upper  lip  referred  to  by  Capt.  Kiblock  stands  almost 
isolated  as  a  clinical  observation  and  constitutes  a  very 
important  contribution  to  the  topography  of  carcinoma 
as  it  is  observed  in  India.  Hundreds  of  cases  of  carci-- 
noma  of  the  lower  lip  have  come  under  my  observation 
and  only  a  single  case  of  carcinoma  of  the  upper  lip. 

ABSCESS  OF  THE  LIVER. 

In  visiting  any  of  the  large  hospitals  in  India  one  is 
sure  to  find  a  few  cases  of  abscess  of  the  liver,  and  vet 


INDIA.  207 

Capt.  W.  J.  Niblock  says  the  disease  is  not  so  frequent 
as  is  generally  supposed.  (Notes  on  operations  for  ab- 
scess of  the  liver,  ascites,  and  gall  stone.  Indian  Medi- 
cal Gazette,  November,  1903.)  In  looking  through  the 
reports  of  the  Madras  General  Hospital,  he  found  that, 
during  the  ten  years,  1893-1902  inclusive,  only  154 
cases  were  operated  on,  and  during  the  last  three  years 
the  average  annual  admissions  were  at  the  rate  of 
63,591.  Of  the  154  cases  recorded,  21  were  shown  to 
be  multiple,  all  of  whom  died.  There  were  53  deaths 
among  the  133  other  cases,  several  of  which  were,  how- 
ever, probably  multiple,  as  some  of  the  surgeons  who 
performed  the  operations  made  no  distinction  between 
single  and  multiple  abscesses  in  their  records.  Capt. 
Niblock  reports  the  result  of  29  cases  of  abscess  of  the 
liver  operated  on  by  himself  from  March  25,  1899,  to 
Sept.  21,  1903.  All  the  patients  were  males,  their  ages 
ranging  between  24  and  70.  The  racial  distribution 
was  as  follows:  Hindu,  19;  Eurasian,  3;  European,  5; 
Mussulman,  2.  Out  of  the  29  cases,  5  were  multiple, 
all  of  whom  died.  Amiong  the  remaining  24  there  were 
G  deaths,  that  is,  the  mortality  was  25  per  cent.  All  of 
the  abscesses  containing  less  than  20  ounces  of  pus  at 
the  time  of  operation  recovered.  In  the  treatment  of 
this  affection  the  author  of  the  paper  emphasizes  the 
importance  of  a  preliminary  exploration  of  the  liver  by 
means  of  a  long  needle  and  syringe. 

His  directions  for  exploring  the  liver  are  as  follows: 
"If  a  distinct  prominence  be  felt  or  seen,  the  needle  is 
first  introduced  at  that  situation.  Where  no  such  prom- 
inence exists,  the  needle  is  nsnally  introduced  into  the 
liver  through  the  ninth  or  tenth  intercostal  space. 
After  the  liver  has  been  pierced,  the  piston  of  the 
syringe  is  drawn  back  for  an  inch  or  so,  leaving  a 
vacuum.  Should  pus  now  enter  the  syringe,  the  latter 
is  detached,  leaving  the  needle  sticking  in  the  liver  to 
act  a?  a  guide.  If  no  pus  be  found,  the  needle  is  gently 
pushed    npward,    inward    and    slightly   backward,    this 


208  AEOUXD    THE    WORLD   VIA    INDIA. 

being  the  most  likely  direction  in  which  to  strike  pus. 
It  is  gradually  withdrawn  if  no  pus  is  found,  and  rein- 
troduced in  another  direction.  Five  or  six  different 
parts  of  the  liver  are  thus  carefully  explored  before  the 
case  is  sent,  back  with  a  negative  result."  The  explora- 
tion is  made  under  an  anesthetic,  and  if  pus  is  found 
the  operation  is  performed  at  once.  After  resection  of 
about  two  inches  of  the  ninth  or  tenth  rib  in  the  axil- 
lary line  the  liver  is  exposed  by  an  incision.  If  adhe- 
sions are  present  the  liver  is  incised  at  once;  if  there 
arc  no  adhesions  a  strip  of  gauze  is  carefully  packed 
all  around  the  proposed  line  of  the  visceral  incision. 
Sutures  are  never  used,  as  they  tend  rather  to  favor 
than  prevent  the  escape  of  pus  into  the  serous  cavities. 
With  a  small  scalpel  the  capsule  of  the  liver  is  incised. 
If  the  abscess  is  deeply  situated  a  sinus  forceps  is  pushed 
through  the  liver  substance  into  the  abscess,  followed 
by  the  index  finger,  and  the  needle  is  then  withdrawn 
and  one  or  two  Keith's  glass  drains  inserted.  After 
evacuation  of  the  pus  one  or  two  large  fenestrated  rub- 
ber drains  are  substituted  for  the  glass  drains  and  a 
large  aseptic  absorbent  dressing  applied.  Washing  out 
the  cavity  with  antiseptic  solutions  is  abstained  from, 
although  the  operator  has  seen  good  results  from  the 
use  of  a  solution  of  quinin,  1  in  60  to  1  in  80,  as  advised 
by  Capt.  L.  Eogers.  I.M.S. 

The  nursing  in  the  Madras  General  Hospital  is  in 
charge  of  28  trained  female  nurses,  51  male  ward  at- 
tendants and  21  female  ward  attendants.  Twelve  fe- 
male nurses  resigned  during  the  year  and  gave  their 
reasons  for  this  step  as  follows :  Left  to  be  married,  6 ; 
left  to  train  as  midwife,  1 ;  retired  on  pension.  2  ;  re- 
tired on  account  of  ill  health,  2 ;  retired  for  private 
reasons,  1. 

The  amount  of  available  clinical  material  of  this 
hospital  is  something  enormous.  During  the  last  year 
the  institution  cared  for  60,842  out-patients  and  7,177 
in-patients.     The  total  number  of  deaths  that  occurred 


INDIA.  209 

in  tl'.o  hospital  was  014.  Aiiiouii-  tin"  most  frequent 
causes  of  death  we  find  malaria.  48;  dysentery,  46; 
tuberculosis,  83;  diseases  of  liver,  38;  diseases  of  the 
iiriiiai'v  organs,  4i).  Cholci'a  is  ei'cdited  with  5  deaths. 
Only  .-)  deaths  ()c('uri'c(l  from  septic  diseases  acquired  in 
the  lios|)ital.  'rhey  v/erc  as  follows:  One  case  of 
sapremia,  1  case  of  septic  ])eritonitis  after  entcrectomy, 
1  case  of  erysipelas  after  operation  on  tubercular  glands 
of  the  neck,  1  case  of  cancrum  oris  occurring  in  a  i)a- 
tient  suffering  from  malaria,  and  1  case  of  gangrene  of 
the  leg  following  the  pueri)eral  state  in  a  debilitated 
woman. 

Forty-eight  deaths  occurred  in  cases  of  septic  dis- 
eases contracted  outside  of  the  hospital,  namely,  K)  from 
tetanus.  9  from  cancrum  oris,  9  from  cellulitis,  3  from 
gangrene,  2  from  sloughing  after  extravasation  of  urine, 
1  from  sloughing  of  scrotum,  1  from  sloughing  phage- 
dena of  penis,  and  7  from  septicemia  (tw^o  puerperal). 

The  total  number  of  operations  performed  was  6,281, 
with  a  mortality  of  only  1.9  per  cent.  Among  the  more 
important  operations  were  43  for  elephantiasis  of  the 
scrotum,  with  1  death ;  8  suprapubic  cystotomies  for 
stone,  with  4  deaths,  1  death  following  a  median  perin- 
eal operation  and  2  litholapaxies,  with  1  death;  61  op- 
erations for  hemorrhoids  without  mortality,  7  by  liga- 
ture, 3  by  excision  and  ol  by  clamp  and  cautery;  10 
operations  for  extravasation  of  urine,  with  1  death;  700 
operations  for  hydrocele  by  tapping,  tapping  with  in- 
jection, incision  and  eversion  of  sac,  excision  of  parietal 
part  of  sac  and  incision  and  drainage;  31  castration? 
without  a  death  ;  5  operations  for  prolapse  of  the  rec- 
tum, with  1  cured,  2  relieved  and  2  deaths;  26  opera- 
tions for  strangulated  hernia,  with  9  deaths,  and  102 
radical  operation*,  with  3  deaths;  31  operations  for 
abscess  of  the  liver,  Avith  3  deaths,  and  15  exploratory 
punctures  of  the  liver,  with  1  death  from  hemorrhage; 
6  exploratory  laparotomies,  with  2  deaths ;  3  operations 
for  intest'nal  obstruction,  with  2  deaths;  5  excisions  of 


210  AROUND    THE    AVORLD   VIA    INDIA. 

the  appendix,  with  1  death,  and  5  incisions  for  appen- 
diceal abscess,  with  1  death;  6  amputations  of  the 
thigh,  with  1  death,  and  10  amputations  of  the  leg, 
with  1  death. 

A  few  of  the  operations  are  of  sufficient  interest  to 
entitle  them  to  a  more  extended  notice  here. 

ANEURISM   OF   COMMON  AND   EXTERNAL   CAROTID 
ARTERIES. 

The  patient  was  a  Hindu,  aged  22  years.  The  pul- 
sating swelling  was  first  noticed  a  year  ago  and  meas- 
ured three  inches  in  diameter  at  its  widest  part.  Pa- 
tient suffered  from  severe  pain  in  the  region  of  the 
swelling  and  on  the  right  side  of  the  head,  slight  dys- 
phagia, paralysis  and  wasting  of  the  right  side  of  the 
tongue.  The  common  carotid  was  ligated  below  the 
omohyoid  October  20.  The  pulsations  in  the  swelling 
facial  and  temporal  arteries  ceased  at  once  and  never 
returned.  The  swelling  steadily  decreased  in  size,  but 
as  the  progress  was  too  slow  to  satisfy  the  patient  it  was 
later  incised  at  his  urgent  request,  the  coagulated  blood 
removed  and,  as  no  hemorrhages  attended  the  opera- 
tion, the  wound  was  sutured  without  making  provision 
for  drainage  and  healed  by  primary  intention. 

HYDATID    CYST    OF    TIBIA. 

Operator,  Captain  Niblock.  The  patient,  a  Hindu 
ryot,  aged  30,  was  admitted  to  hospital  for  a  tumor  of 
the  upper  end  of  the  right  tibia.  He  gave  a  history  of 
the  swelling  commencing  seven  months  before  and  grad- 
ually increasing;  also  of  indefinite  pain  and  wealcness 
in  the  leg  for  two  years.  Pain  never  severe.  The 
tumor  on  examination  was  hard,  smooth,  and  fairly 
regular  in  outline,  no  eggshell  crackling.  The  tumor 
was  diagnosed  as  possible  myeloid  sarcoma,  but  on  being 
incised  it  was  discovered  to  be  a  hydatid  cyst,  containing 
about  10  ounces  of  fluid.  The  cyst  wall  was  removed 
thorou<Thlv  and  the  bonv  shell  of  the  cvst  broken  and 


INDIA.  211 

turned  inward  so  as  to  partially  fdl  the  cavity.    He  left 
tlif  ]io<|)ital  cured  in  four  months. 

RIIINOSCLEROMA. 

The  i^atient  was  an  Eurasian,  21  years  old,  fireman  by 
occiiiDation,  resident  in  India  since  birth,  spent  most  of 
his  time  at  Bhunda  Ekhand,  Jhansi.  Admitted  on  July 
30,  suffering  from  most  typical  rhinoscleroma,  affecting 
nose,  palate  and  ph:arynx.  No  history  of  any  member 
of  his  famil}'  ever  having  suffered  from  a  similar  com- 
plaint nor  has  he  ever  seen  the  disease  in  any  other 
person.  Three  years  ago  he  first  noticed  a  small  hard 
pimple  on  the  skin  of  the  right  side  of  the  nose — about 
the  middle;  at  the  same  time  he  suffered  from  occa- 
sional attacks  of  epistaxis.  The  hemorrhage  stopped 
entirely  after  six  months  and  has  never  recurred.  The 
growth  slowly  but  steadily  extended  until  the  greater 
part  of  his  nose  became  affected,  and  then  involved  the 
upper  lip,  soft  palate  and  pharynx.  Captain  Cornwall. 
I.M.S.,  isolated  the  bacillus,  from  which  he  made  pure 
cultures  and  also  rhinosclerin,  which  was  tried  without 
success.  Large  doses  of  carbolic  acid  and  idoform 
administered  internally  proved  likewise  useless.  Par- 
tial excision  and  applications  of  formalin,  and  more 
recenth'  the  .'c-rays,  have  been  tried,  under,  which  treat- 
ment the  disease  appears  to  have  become  stationary. 

There  are  no  gynecologists  connected  with  the  Ma- 
dras General  Hospital,  the  attending  surgeons  being 
in  charge  of  all  surgical  cases  regardless  of  sex.  The 
hospital  has  nine  private  rooms,  for  which  the  patients 
are  charged  from  2  to  5  rupees  a  day  (.64  to  $1.60). 

Bubonic  plague  cases  occasionally  find  their  way  to 
Madras,  but  the  sanitary  precautions  are  so  stringent 
that  the  disease  has  never  gained  a  foothold  here.  Every 
stranger  who  arrives  at  Madras  by  boat  or  railway  is 
kept  track  of  by  the  police  for  10  days,  the  maximum 
limit  of  the  period  of  incubation  of  bubonic  plague. 

Calcutta,  Ixdia,  Sept.   17,   1904. 


BENGAL  MEDICAL  COLLEGE  AND  CALCIJ'J'TA 
GOVEENMENT   GENERAL   HOSPITAL. 


The  medical  interests  of  Calcutta,  a  city  of  great 
comnun-cial  importance,  with  nearly  a  million  of  inhahi- 
tants,  center  in  the  Bengal  Medical  College  and  the 
Government  General  Hospital;  its  clinical  department, 
college  and  hospital  are  located  on  the  same  spacious 
grounds  artistically  laid  out,  intersected  by  well-made 
and  well-kept  walks  and  ornamented  with  trees,  shrub- 
bevy   and    flowers.      (Fig.   40.)      Both   institutions   are 


^ 

H^xJiiluf^ 

III  w\ 

1M1 

^ 

mM 

S^r>r*ip#   '     4^.    .,' 

Pf     m^ 

■P-  ■       -     '^1 W^M 

Fig.   40. — Bengal    Medical   College,   Calcutta. 

managed  by  officers  of  the  Indian  Medical  Service, 
who  constitute  the  faculty  of  the  college  and  attending 
staff  of  the  hospital,  thus  cementing  together  the  didac- 
tic and  clinical  teaching  and  nniting  them  practically 
under  one  administration,  and  securing  imiformity  in 
the  methods  of  teaching  and  a  systematic  progression 
of  the  courses  from  term  to  term  and  year  to  year. 

BENGAL    MEDICAL    COLLEGE. 

The  Bengal  Medical  College  was  founded  in  1830, 
and  from  a  small  beginning  has  gradually  developed 
into  a  gTeat  medical  school  with  an  attendance  at  the 
present  time  of  about  600  students.  The  original 
structure  is  an  imposing,  massive  stone  building  with 


214  AEOUXD   THE    WORLD    VIA    INDIA. 

graceful  fluted  columns  and  broad  stone  steps  on  the 
side  of  entrance.  The  college,  as  well  as  the  hospital 
which  in  reality  forms  an  integral  part  of  it,  had  to  be 
enlarged  from  time  to  time  in  order  to  accommodate 
the  rapidl}^  increasing  number  of  students.  The  re- 
quirements for  admission  and  graduation  correspond 
with  those  of  the  other  medical  colleges  of  India.  Sep- 
arate laboratory  buildings  have  been  erected,  well 
adapted  for  the  purposes  for  wliich  they  are  intended 
and  fairly  well  equipped.  The  medical  classes  are  very 
much  mixed,  not  only  in  nationality  and  color,  but  also 
in  the  different  aims  pursued  by  the  students.  Thus 
there  are  "regular"  and  "casual"  students;  the  former 
continue  their  studies  for  five  3'ears  with  a  view  of  pass- 
ing the  final  examinations  for  the  L.M.S.  or  M.B.  de- 
gree ;  the  latter  are  permitted  to  take  a  partial  course  of 
lectures  or  any  department  of  hospital  practice,  with 
the  permission  of  the  principal  of  the  school  and  the 
professor,  on  payment  of  the  fees  in  advance  at  the 
fixed  rates. 

Then  there  are  special  provisions  made  for  female 
medical  students  and  military  pupils.  Admission  to 
the  female  certificate  course  is  granted  by  the  principal, 
provided  the  student  has  passed  the  preliminary  arts 
examination.  Admission  to  the  military  pupil  course 
is  regulated  by  the  director-general  of  the  Indian  Medi- 
cal Service.  I  am  particularly  anxious  to  define  in  con- 
nection with  the  Bengal  Medical  College  the  status  of 
female  medical  students  in  the  medical  colleges  of 
India.  Female  students  may  enter:  a.  As  regular  stu- 
dents for  the  university  course;  h,  as  female  certificate 
students;  c,  as  casual  students.  The  preliminary  arts 
examination  required  before  entering  is:  a.  The  F.A., 
Calcutta,  or  its  equivalent ;  h,  the  entrance,  or  its  equiv- 
alent; c,  a  student  who  has  entered  for  tlie  university 
course  may  be  permitted  by  the  principal  to  change  her 
plans  of  studies  at  any  stage,  and  to  join  the  certificate 
class  instead.     Female  students  entering  as  regular  or 


INDIA. 


215 


female  eortiiicate  students  arc  eligible  for  a  govei'iimeiit 
scholarship,  2U  rupees  per  montli,  and  are  not  charged 
any  fees. 

FEMALE    CERTIFICATE   CLASS. 

Admission  to  this  class  is  granted  by  the  principal. 
The  number  of  admissions  is  determined  by  him. 
Students  of  this  class  must  be  over  17  years  of  age  be- 
fore commencing  their  studies.  They  must  have  passed 
a   preliminary   arts   examination   before   admission   to 


Fig.   41. — Quarters   for   miUtary   pupils. 

the  college,  viz.,  1,  entrance  examination  of  the  Cal- 
cutta University  or  an  equivalent ;  2,  a  preliminary  arts 
examination  recognized  by  the  British  general  medical 
council. 

THE    SURNOMOYE    HOSTEL. 

All  female  students  are  expected  to  reside  in  the 
hostel,  located  in  the  college  grounds,  and  only  under 
exceptional  circumstances  will  they  be  allowed  to  live 
with  friends  or  guardians  outside  the  college.  Applica- 
tion«  may.  therefore,  have  to  be  refused  on  the  ground 
that  there  is  no  accommodation  in  the  hostel.     Under 


316  AROUND    THE    WORLD   VIA    INDIA. 

tlie  rules  of  the  hostel  preference  is  given  to  native  stu- 
dents. ^Yhile  in  the  hostel  students  are  under  the 
supervision  of  the  lady  superintendent  and  must  con- 
form to  the  rules  laid  down  for  their  guidance.  While 
within  the  college  precincts  students  are  under  the 
disciplinar}^  control  of  the  principal. 

MILITARY  PUPIL  CLASS. 

The  jsresent  attendance  of  Bengal  Medical  College 
includes  96  military  pupils  who,  at  government  ex- 
pense, are  being  educated  for  the  subordinate  Indian 
Medical  Service.  These  students  are  in  uniform  and 
reside  in  a  separate  building  across  the  street  from  the 
college  (Fig.  41),  and  besides  pursuing  their  routine 
studies,  are  drilled  daily  by  a  retired  captain  of  the  In- 
dian army,  who  at  the  same  time  exercises  supervision 
over  them  and  is  responsible  for  their  conduct  outside 
Oi  the  college  precincts.  The  following  are  the  regula- 
tions for  this  class :  1.  The  administrative  control  of 
this  class,  as  a  portion  of  the  Indian  subordinate  medi- 
cal department,  rests  with  the  director-general  of  the 
Indian  Medical  Service.  2.  Students  are  admitted  to 
this  class  under  the  orders  of  the  government  of  India, 
military  department.  3.  Students  must  be  of  European 
or  Eurasian  parentage,  physically  fit,  of  good  character, 
and  betwe.en  16  and  18  years  of  age  on  admission. 
4.  AYhile  at  the  college  they  will  be  styled  militar)^  pu- 
pils. 5.  Their  education  at  the  college  is  intended  to 
fit  them  for  employment  in  hospitals  of  British  troops 
and  in  military  and  civil  appointments.  6.  The  course 
of  study  is  four  years.  7.  Military  pupils  must  obtain 
permission  from  the  principal  before  attending  lec- 
tures on  subjects  outside  their  curriculum.  8.  The  peri- 
odical and  final  examinations  of  the  curriculum  will  be 
conducted  by  the  faculty,  and  students  who  fail  to  pass 
them  wnll  be  dealt  with  in  accordance  with  the  rules 
laid  down  in  the  prospectus  issued  by  the  director- 
general  of  the  Indian  Medical  Service.     9.  At  the  end 


INDIA.  317 

of  the  course  niilitary  pu])ils,  if  repoi'ted  qualified,  will 
be  attested  and  admitted  into  the  Indian  sul)ordinate 
medical  department.  10.  At  the  same  time  tiiey  will 
receive  a  certificate  qualifying  them  to  practice  physic 
in  India  and  desigiiate  themselves  diplomates  of  the 
Medical  College  of  Bengal.  11.  iV  military  pupil  who, 
at  the  end  of  his  first  year  at  the  college,  does  not,  in 
the  opinion  of  the  principal,  give  promise  of  proving  a 
successful  or  desirable  student,  will  be  liable  to  removal. 
12-  A  military  pupil,  in  the  event  of  failing  to  pass  the 
periodical  and  final  examinations  of  the  curriculum, 
or  misconducting  himself,  may  be  summarily  removed 
by  the  director-general  of  the  Indian  Medical  Service, 
and  all  certificates  to  which  he  may  otherwise  be  en- 
titled withheld.  13.  A  military  pupil  desirous  of  re- 
linguishing  his  studies  can  do  so  only  with  the  sanction 
of  the  director-general,  and  on  refunding  the  Avhole 
amount  of  pay  received  by  him.  14.  A  military  pupil 
who,  after  completing  the  course,  declines  to  be  attested, 
will  similarly  refund  the  whole  amount  of  pay  received 
by  him,  and  will  not  receive  any  certificates.  15.  The 
order  and  discipline  of  the  military  pupils  is  main- 
tained by  the  superintendent  of  military  pupils  and 
the  resident  staff,  under  orders  of  the  principal.  16. 
While  under  instruction  in  the  college  or  hospitals 
military  pupils  are  subject  to  the  rules  for  the  main- 
tenance of  discipline  applicable  to  other  students.  17. 
Leave  of  absence  to  military  pupils  is  granted  by  the 
principal.  18.  No  certificate  of  attendance  on  any 
course  of  lectures,  or  practical  work,  will  be  gTanted 
to  a  military  pupil  unless  he  has  passed  the  entrance 
examination  of  the  Calcutta  university,  or  its  equiva- 
lent, before  commencing  the  course,  and  has  also  paid 
the  fees  laid  down  for  casual  students. 

Female  medical  students  who  enter  the  certificate 
class  continue  their  studies  for  four  years  and  are  re- 
quired to  pass  a  satisfactory  examination  in  the  fol- 
lowing branches. 


218  AROUND    THE    WORLD   VIA    INDIA. 

First  Year. — Descriptive  and  surgical  anatomy,  gen- 
eral anatomy  and  pliysiolog}-,  materia  mediea,  element- 
ary chemistry,  dissection,  practical  pharmacy,  followed 
by  a  test  examination  in  anatomy,  jjhysiolog}^  ma- 
teria niedica  and  chemistry. 

Second  Year. — Descriptive  and  surgical  anatom}-, 
general  anatomy  and  physiology,  materia  medica,  chem- 
istry (full  course),  dissections  (six  postmortems), 
nine  months'  hospital  practice,  three  months'  out-pa- 
tient practice,  to  be  followed  by  a  final  examination  in 
anatomj^,  physiology,  materia  medica,   and   chemistry. 

TJiird  Year. — Medicine  and  clinical  medicine,  sur- 
gery and  clinical  surgery,  midwifery,  medical  juris- 
prudence, pathology,  practical  midwifery  (three  la- 
bors), ophthalmic  medicine  and  surger}^,  six  postmort- 
ems, nine  mouths'  hospital  j)ractice,  tliree  months' 
ophthalmic  hospital  practice,  to  be  followed  by  final 
examination  in  patholog}'  and  medical  jurisprudence. 

Fourth  Year. — Medicine  and  clinical  medicine,  sur- 
gery and  clinical  surgery,  midwifery,  practical  mid- 
wifery (six  cases  of  labor),  three  months'  hospital 
practice,  midwifery  wards  (six  months),  dental  out- 
patient practice  (three  months),  dental  surgery  (op- 
tional), to  be  followed  by  final  examinations  in  medi- 
cine and  surgery  and  midwifery. 

It  will  be  seen  from  the  above  that  in  the  whole  curri- 
culum there  is  only  one  optional  branch — dental  sur- 
gery. The  English  teachers  of  medicine  and  surgery 
believe  in  the  wisdom  of  making  the  attendance  on  all 
lectures  and  clinics  obligatory,  as  it  should  be.  Some  of 
our  best  American  medical  colleges  are  making  a  seri- 
ous mistake  in  giving  the  students  too  much,  liberty  in 
the  choice  of  their  studies,  the  results  of  which  must 
necessarily  be  a  fragmentary  and  imperfect  knowledge 
in  some  of  the  most  important  branches  they  are  ex- 
pected to  master.  Optional  liberties  in  a  medical  col- 
lege are  as  harmful  as  they  would  be  if  they  were  intro- 
duced into  our  primary  schools.     Students  thus  priv- 


XDIA. 


219 


ilegetl  will  only  Icnrn  fiKHigli  <ii'  Hit'  Ijiaiiclics  that  are 
distasteful  to  tlicin  to  squeeze  through  the  (iual  exam- 
inations and  no  more.  Optional  stiulies  are  in  place 
in  post-graduate  education,  but  should  not  be  coimten- 
anced  in  a  medical  college  whose  function  it  is  to  in- 
struct the  students  systeraatically  and  thoroughly  in 
all  branches  pertaining  to  medicine  and  surgery. 

'J'he  Bengal  Medical  College  has  undertaken  the  edu- 
cation of  midwives,  a  very  commendal)le  extension  of  its 
wide  field  of  usefulness. 

]\IIDW1VES    AND   DIAS. 

The  regulations  for  this  department  are  formulated 
under  this  heading : 

A^'omen  who  have  a  fair  knowledge  of  English,  l)ut 
who  have  not  passed  the  entrance  examination  or  its 
equivalents,  will  be  admitted  into  the  Eden  Hospital 
to  learn  midwifery.  The  government  grants  20  rupees 
($6.40)  a  month  toward  the  board,  washing,  etc.,  of 
each  pupil  and  gives  them  free  quarters.  After  a  year's 
tuition  and  ])edside  practice,  if  found  proficient,  they 
will  obtain  a  certificate  qualifying  them  to  practice 
midwdfery.  The  fee  for  each  certificate  is  5  rupees 
($1.G0).  They  are  expected  to  do  general  nursing  in 
the  wards  as  well  as  midwifery.  Women  who  have  not 
passed  the  entrance  examination  or  its  equivalents,  but 
who  can  read  and  Avrite  Bengali,  can  be  admitted  into 
the  Eden  Hospital  as  pupil  dais.  The  government 
g-rants  6  rupees  ($1.92)  each  month  to  eight  pupils 
toward  their  board,  washing,  etc.,  and  gives  them  free 
quarters.  After  twelve  months'  tuition  and  bedside 
practice,  if  found  proficient,  they  will  obtain  a  certifi- 
cate qualifying  them  to  practice  midwifery.  They  are 
expected  to  do  nursing  in  the  wards  as  well  as  mid- 
wdfery. The  education  of  these  two  classes  of  midwives 
for  country  and  village  practice  must  meet  a  pressing 
need,  as  in  many  remote  parts  of  India  medical  aid 
is  too  remote  to  be  available  in  obstetrical  cases.    These 


220  AROUND  THE  WORLD  VIA  INDIA. 

women  can  be  made  also  very  useful  to  physicians  and 
patients  as  nurses  in  grave  cases  of  illness  or  accident. 
Major  P.  J.  Drury,  I.M.S.,  is  principal  of  the  college, 
and  Professor  Bird  occupies  the  chair  of  surgery. 

CALCUTTA    GOVERNMENT    GENERAL    HOSPITAL. 

The  Calcutta  Government  General  Hospital  is  vir- 
tually the  clinical  part  of  the  Bengal  Medical  College. 
The  dift'erent  pavilions  and  laboratories  form  a  group 
of  buildings  of  wliich  any  city  and  country  might  well 
be  proud.  The  Eden  Hospital  (Pig.  43),  a  separate, 
new  modern  building,  is  the  maternity  in  which  about 
600  women  are  delivered  every  year.  The  strictest 
cleanliness  prevails  throughout  this  building  and  sep- 
sis in  in-patients  is  almost  unknown.  The  woman  in 
labor  is  prepared  with  the  same  care  as  for  a  major 
operation,  and  ever}i;hing  brought  in  contact  with  her 
during  the  delivery  and  lying-in  period  is  carefully  dis- 
infected (hands)  and  sterilized  (dressings).  The  de- 
livery room  has  all  the  aspects  of  an  operating  room. 
Three  tables  are  always  kept  in  readiness.  Mother  and 
child  remain  in  the  hospital  from  ten  to  fourteen  days 
after  delivery.  The  Ezra  ward,  with  forty  beds,  the 
gift  of  a  rich  Jew,  is  for  the  exclusive  use  of  Jews.  The 
original  hospital  building  is  an  old-fashioned  two- 
story  solid  stone  building  which  in  the  light  of  modern 
improvements  would  appear  somewhat  antic[uated  if  it 
were  not  for  the  electric  lighting  and  electric  punkah 
motor.  The  latter  is  kept  in  motion  night  and  day 
during  the  hot  season  and  is  a  source  of  immense  com- 
fort to  the  patients.  The  hospital  can  accommodate 
450  patients  and  has  a  few  private  rooms  for  which  a 
charge  of  23  rupees  (64  cents)  a  day  is  made.  The 
operating  room  has  a  small  amphitheater  which  affords 
standing  room  for  the  students,  but  lacks  many  of  the 
conveniences  and  appliances  considered  at  the  present 
time  so  essential  for  aseptic  surgical  work.  As  in  all 
hospitals  in  India,  chloroform  is  the  favorite  anesthetie 


INDTA. 


223 


and  the  biiiiodid  ol'  iiicftiii-v  iakcs  the  first  place  as  an 
antiseptic.  IJuricd  sutures  liave  been  abandoned  al- 
most entirrly  and  the  rciiinvahle  silk  and  silkworingut 
sutures  aiv   in   ^cneial    ii^e.     The   nursinii-  is  in  charo-e 


Fig.  43.-  ]LkijLiaiitLia.sis  ol  leys.     JJy  coiirtoyy  of  Cayt.  Uogcrs,  I. M.S. 

of  two  Anglican  sisters,  who  are  also  at  the  head  of  a 
recently  organized  training  school  for  female  nurses, 
which  has  now  an  attendance  of  forty  pupils.  Male 
and  female  ward  attendants  assist  the  nurses  in  their 


224  AROUND    THE    WORLD   VIA    INDIA, 

work.  The  pupil  nurses  are  Europeans  or  Eurasians 
and  remain  for  only  one  year  in  training. 

Among  the  more  interesting  cases  Professor  Bird 
showed  me  five  patients  recently  operated  on  for  abscess 
of  the  liver.  All  were  doing  well,  although  greatly 
emaciated  from  the  effects  of  the  disease.  Abscess  of 
the  liver  appears  to  be  extremely  common  in  this  part 
of  India,  as  Professor  Bird  not  long  ago  operated  on 
twenty  cases  in  two  months.  Carcinoma  in  all  its 
forms  is  met  with  here  with  about  the  same  frequency 
•as  in  Europe.  Acute  osteomyelitis  and  surgical  tuber- 
'culosis,  on  the  other  hand,  are  comparatively  rare. 
Syphilis  and  gonorrhea  are  very  common,  but  in  the 
native  both  of  these  diseases  pursue  a  benign  course. 
Enlargement  of  the  prostrate  gland  in  the  aged  natives 
is  very  rare.  This  statement  is  confirmed  by  all  sur- 
geons I  met  in  India.  They  can  offer  no  explanation 
for  this,  but  there  must  be  something  in  their  habits 
or  manner  of  living  that  protects  them  against  this 
curse  of  advanced  life  so  common  among  Europeans 
and  Americans.  Stone  in  the  bladder  is  very  common, 
but  comparatively  few  of  these  cases  enter  the  hos- 
pital, as  they  are  operated  on  by  physicians  who  prac- 
tice in  the  country  districts,  the  operation  being  re- 
garded by  them  as  a  safe  and  easy  one. 

A  chronic  parenchymatous  inflammation  of  the 
mammary  gland  in  young  men  is  of  frequent  occur- 
rence here  anji  is  usually  treated  by  excision.  Cystitis 
is  very  rare  as  compared  with  our  hospital  experience. 
Two  reasons  might  be  advanced  to  explain  this:  the 
rarity  of  prostatic  hypertrophy  in  India  and  the  very 
mild  course  gonorrhea  pursues  in  the  natives. 

Professor  Quicke,  of  Bombay,  made  the  statement 
to  me  that  he  never  knew  of  a  rajah  to  enter  on  a  cath- 
eter life.  Tuberculosis  of  the  kidney  and  bladder  is 
also  infinitely  more  rare  in  India  than  in  our  country. 
As  is  the  case  with  all  colored  races,  the  natives  of  In- 
dia are  very  subject  to  benign  tumors,  especially  fibro- 


INDIA. 


225 


nia,  keloid,  lipoma,  papilloma  and  cystoma.  On  llici 
other  hand,  all'ections  of  the  veins,  hemorrhoids,  vari- 
cocele and  varicose  veins  of  the  lower  extremities,  are 
not  nearly  as  frequent  as  with  us.  Among  the  thousands 
■oi  barelegged  men  I  saw  in  India  I  did  not  observe  a 
single  instance  of  well-marked  varicosity  and,  consid- 


Fig.  ii. — An  undiagnosed  case.     By  courtesy  of  Capt.  Rogers,  I.M.S. 

ering  the  enormous  clinical  material  that  passes  through 
the  large  hospitals,  the  number  of  operations  for  hem- 
orrhoids and  varicocele  is  astonishingly  small.  Ijaxa- 
tive  vegetable  diet,  active  exercises,  absence  of  tendency 
to  obesity  and  looseness  or  absence  of  dress  will  go  far 
to  explain  the  comparative  freedom  from  ectatic  dis- 
ease of  the  hemorrhoidal,  spermatic  and  saphenous 
veins,  a  suggestion  which  might  be  of  some  service  to 
our  numerous  sufferers  from  plethora,  obesity  and  stag- 
nant venous  circulation. 


226  AROUND    THE    WOULD    VIA    INDIA. 

In  the  medical  wards  I  found  here,  as  in  all  hospitals 
in  India,  the  greatest  variet}'  of  malaria  and  its  mul- 
titude of  complications.  A  large  part  of  the  hospital 
space  is  occupied  by  malarial  patients  and  the  physi- 
cians here  have  an  excellent  opportunity  throughout 
the  entire  year  to  study  malaria  in  all  its  endless  clini- 
cal and  pathologic  aspects. 

What  an  excellent  place  Bombay  or  Calcutta  would 
be  for  a  great  school  for  the  study  of  tropical  dis- 
eases !  The  material  is  here,  and  not  in  London  nor 
Liverpool,  and  if  utilized  to  greatest  advantage  ir  must 
be  studied  here  and  not  thousands  of  miles  away  from 
Avhere  the  diseases  had  their  origin. 

Typhoid  fever  is  not  so  common  as  we  wouhl  suspect 
after  an  inspection  of  the  water  supply  and  insani- 
tary environments  of  the  masses  of  the  natives.  The 
naiive  prefers  to  draw  his  water  from  the  well  that  has 
served  liis  ancestors  for  centuries  rather  than  from  the 
tap  of  the  modern  water-works.  If  it  is  at  all  within 
reach,  water  from  the  sacred .  Ganges  is  his  favorite 
drink.  Most  of  the  cases  of  typhoid  fever  I  examined 
in  the  different  hospitals  of  India  were  of  a  mild  type, 
and  the  mortality  from  this  disease  as  published  in  the 
hospital  reports  is  not  great. 

India  has  its  share  of  pulmonary  tuberculosis,  l)ut  for 
reasons  that  can  not  be  explained  tuberculosis  of  bones 
and  joints  is  very  rare  as  compared  with  the  frequency 
with  which  this  disease  attacks  our  childhood  popula- 
tion. In  any  of  our  large  hospitals  we  see  ten  cases  of 
Joint  and  bone  tuberculosis  to  one  in  the  hospitals  of 
India,  and  on  the  streets  of  Chicago  ten  cripples  from 
this  disease  to  one  in  India.  The  same  remarks  apply  to 
tuberculosis  of  the  lymphatic  glands  and  genito-urinary 
organs.  Diarrhea,  dysentery  and  malaria  are  the  pre- 
va'ling  diseases  of  India  and  it  is  these  affections  that 
tax  most  heavily  the  therapeutic  resources  of  the  physi- 
cians, both  in  hospital  and  private  practice.  In  this 
as  well  as  in  all  clinical  hospit'^ls  of  India,  much  stress 


INDFA.  227 

is  placed  on  the  practical  training  oi'  the  students,  more 
especially  by  bedside  instruction.  The  out-patient  de- 
partment is  utilized  to  the  greatest  advantage  and  it  is 
here  that  the  students  are  given  the  very  best  oppor- 
tunities to  come  in  touch  with  the  patients.  Under 
tlie  su})crvision  and  guidance  of  the  professors  or  com- 
petent instructors,  they  are  required  to  make  thorough 
clinical  examinations,  apply  dressings  and  assist  in  the 
operative  work,  and  the  last  year  students  are  privileged 
to  perform  some  of  the  minor  operations. 

'J'he  average  medical  student  in  India  has  a  keener 
taste  for  practical  work  than  for  scientific  research, 
and  consequently  makes  good  use  of  his  clinical  oppor- 
tunities. The  female  medical  students  are  no  exception 
to  this  rule,  although  it  is  generally  admitted  that  at 
the  end  of  the  curriculum,  in  consequence  of  a  more 
diligent  attendance  on  the  didactic  lectures  and  a  more 
liberal  use  of  midnight  oil  in  reading  their  text-l)ooks, 
they  are  ahead  of  their  male  colleagues  in  the  theoreti- 
cal knowledge  of  medicine.  The  male  students  are  very 
fond  of  all  kinds  of  athletic  sports,  and  the  time  spent 
by  tliem  in  developing  their  physical  strength  is  made 
use  of  by  the  women  in  committing  to  memory  the 
contents  of  their  text-books.  Then.  too.  the  young  men 
spend  more  time  in  amusements  when  away  from  the 
playgrounds  and  out  of  the  hospital  and  lecture-rooms 
than  the  young  women,  who  have  less  desire  in  this  di- 
rection and  are  kept  under  stricter  supervision. 

If  I  had  any  criticism  to  offer  in  the  methods  of 
teaching  clinical  surgery  in  India  I  would  say  that  the 
clinical  material  and  specimens  obtained  by  operations 
and  postmortems  are  not  made  use  of  to  the  greatest 
advantage  for  the  benefit  of  the  students.  Pathology 
should  be  made  the  most  important  feature  in  the 
teaching  of  surgery  as  well  as  of  medicine.  In  defense 
of  this  apparent  neglect  it  must  be  said  that  the  clini- 
cal teachers  in  some   of  the   colleges  are  without  the 


228  AROUND    THE    AVOKLD   VIA    INDIA. 

necessarj^  appliances  and  equipments  to  give  surgical 
pathology  the  prominence  it  so  well  deserves. 

It  was  in  the  pathologic  laboratory  of  the  Bengal 
Medical  College  that  I  was  given  an  opportunity  to  ex- 
amine a  new  parasite,  the  Piroplasma  donovani, 
through  the  courtesy  of  the  director  of  the  laboratory, 
Capt.  Seward  Eogers,  I.]\I.S.  He  was  also  kind  enough 
to  furnish  me  with  several  mounted  slides  containing 
this  parasite  so  recently  discovered  by  Leishman  and 
Donovan.  In  another  place  I  will  give  a  more  de- 
tailed account  of  this  parasite,  history  of  its  discovery 
and  etiologic  relationship  to  splenic  anemia.  Medical 
science  is  much  indebted  to  the  researches  of  the  mem- 
bers of  this  corps,  many  of  whom  are  indefatigable 
workers  in  a  climate  well  calculated  to  undermine  phy- 
sical strength  and  paralyze  mental  activity. 

Port  Said,  Egypt,  Sept.  26,  1904. 


THE    CITY    OF    JAIPUR,    i:J^DIA,    AND    MAYO 
HOSPITAL. 


Jaipur  is  one  of  the  largest,  most  importaut  and  in- 
teresting inland  cities  of  India.  It  is  the  local  seat  of 
government  of  the  state  of  Jaipur  and  the  residence 
of  the  maliarajah,  whose  palace,  extensive  gardens, 
crocodile  tank,  state  and  private  carriages  and  elephant 
stables  are  objects  of  growing  interest  to  every  visitor. 

The  city  proper  is  enclosed  by  towering  walls  and 
the  two  gates  are  closed  and  locked  regularly  at  10 
o'clock  every  evening,  in  the  same  manner  as  was  done 
300  years  ago,  when  they  were  first  opened  during  the 
feudal  times,  to  serve  as  a  safeguard  against  nightly 
invasions.  This  old  custom  continues  with  great  punc- 
tuality, although  the  protection  for  safety  of  life  and 
property  has  become  superfluous  since  the  strong  arm 
of  the  English  government  has  done  away  with  internal 
strife  and  has  made  India  secure  against  invasion  from 
without. 

Jaipur  has  taken  the  place  of  the  ancient  capital 
city  Amer,  a  mountain  stronghold  seven  miles  distant, 
once  a  great  and  prosperous  city,  now  deserted  and  its 
great  palace  and  former  mansions  and  ramparts  crumb- 
ling into  dust.  A  great  fort  on  the  highest  mountain 
ridge  overlooking  the  ancient  palace  and  depopulated 
city  is  kept  in  good  repair  and  is  occupied  by  a  regi- 
ment of.  native  troops.  Looking  at  this  great  city,  now 
in  ruins,  centuries  ago  the  power  and  pride  of  this  part 
of  India,  the  safe  refuge  of  a  large  and  prosperous 
population,  the  seat  of  a  gay  and  powerful  nobility,  we 
are  strongly  reminded  of  the  significance  of : 

"The  fashions  of  human  affairs  are  short  and 
changeable  and  fortune  never  remains  long  indul- 
gent to  men." — Quintus  Curtius  Rufus. 

A  few  coolies  and  numerous  monkeys  make  up  the 


230 


AROUND    THE    WORLD    VIA    INDIA. 


scanty  population  of  the  abandoned  capital  city  which 
centiiries  ago  was  the  seat  of  political  power,  fashion, 
wealth   and  general  iDrosperity. 

In  the  meantime  its  rival,  Jaipur,  has  become  old. 
The  present  population  of  Jaipur  is  about  85,000;  the 
principal   streets   arc   wide,   lined   by  houses  three  and 


-Native  ol  Jaipur. 


four  stories  high,  with  walls  covered  with  plaster, 
painted  a  light  uniform  roseate  hue,  ornamented  with 
rude  artistic  designs  in  white,  representing  plants  and 
flowers.  This  is  the  place  to  see  the  real  types  of  natives 
(Fig.  45),  their  habits  and  customs  unaffected  by 
time  and  European  influence. 


Fig.   4C. — Ilinclu   flancing   girl. 


IXDIA.  233 

Agrieiiltiirc,  gardening  and  the  different  industries 
arc  conducted  in  the  same  manner  now  as  they  were  a 
tliousand  and  more  years  ago.  The  elephant,  camel, 
donkey  and  buffalo  are  the  beasts  of  burden  now  as 
then,  and  are  trained  and  used  in  the  same  manner  as 
under  the  masters  of  centuries  ago.  The  little  open 
shops  and  corners,  where  the  artisans  do  their  work 
with  the  crudest  kind  of  tools,  are  the  same  now 
as  they  were  when  first  opened  for  business,  hundreds 
of  generations  ago. 

This  is  the  place  to  see  Hindu  feasts  and  processions 
in  their  original  form.  The  Hindu,  above  any  other 
people,  is  proud  of  his  race,  his  ancestry  and  ancient 
civilization,  and  is  deeply,  almost  hopelessly,  rooted  in 
the  teachings  and  faith  of  his  Brahmin  religion.  Hindu 
life,  habits  and  customs  as  seen  in  Jaipur  illustrate  the 
meaning  of: 

"So  difHcult  is  it  to  bring  people  to  approve  of 
any  alteration  of  ancient  customs;  they  are  al- 
ways naturally  disposed  to  adhere  to  old  prac- 
tices unless  experience  evidently  proves  their 
inexpediency." — Livius. 

The  greatest  trouble  with  the  Hindu  is  to  convince 
him  of  the  inexpediency  of  anything  inaugurated  by 
his  ancestors,  as  he  is  a  firm  believer  in  their  infalli- 
bility concerning  happiness  in  life  and  an  ascending 
scale  of  blessedness  in  the  hereafter. 

Jaipur  represents  the  center  of  one  of  the  most  fer- 
tile and  prosperous  agricultural  states  in  India.  Indi- 
cations of  considerable  local  wealth  in  the  city  are  not 
lacking.  •  The  reigning  maharajah  is  very  popular  and 
is  well  and  favorably  known  for  his  many  unostenta- 
tious works  of  charity.  It  was  this  prince  who,  during 
the  last  long  famine,  kept  hundreds  of  his  poor  subjects 
from  starving  by  his  liberal  contributions  of  food  and 
money.  He  is  a  friend  of  the  poor  and  takes  a  paternal 
interest  in  the  Mayo  Hospital. 

Medical  affairs  in  the  city  and  state  of  Jaipur  are 
managed  by  P.  Durrel  Pank,  Lieutenant  Colonel,  I.M.S. 


234  AROUND  THE  WORLD  VIA  INDIA. 

His  last  official  report^  contains  many  interesting  facts, 
and  from  it  I  have  gleaned  much  valuable  information. 

In  speaking  of  the  temperature  and  rainfall  he  says: 
"The  mean  temperature  was  77.7  F.,  or  0.9  F.  above  the 
average;  the  maximum  temperature  was  115.30  F.,  on 
June  3  and  13,  and  the  minimum  35  F.  on  December 
27:  the  amplitude  of  yearly  fluctuation  was  80.3  F., 
and  the  greatest  on  any  day  was  41.4  F.,  on  February  9. 
The  rainfall  registered  at  the  Jaipur  Observatory  was 
23.39  inches,  or  1.07  below  the  yearly  average." 

The  vital  statistics  show  that  during  the  year  1903 
the  number  of  births  recorded  was  4,436,  against  6,641 
deaths,  the  death  rate  being  much  larger  than  the  birth 
rate.  Infantile  mortality  is  responsible  for  the  large 
death  rate,  as  the  number  of  deaths  among  children 
under  one  and  five  years,  during  the  same  time  reached 
the  astonishing  figure  of  3,863.  The  three  months  most 
fatal  to  child  life  were:  June,  531;  October,  461,  and 
September,  459.  During  the  year  there  were  58  deaths 
from  smallpox,  244  from  measles,  7  from  cholera  and 
7  from  imported  plague  in  Jaipur  city. 

In  reference  to  the  steps  taken  to  check  the  cholera 
epidemic  the  report  states:  "The  usual  necessary  pre- 
cautions were  taken  in  every  village  and  city  where  the 
outbreak  of  cholera  took  place — ^wells  were  disinfected 
with  permanganate  of  potassium;  insanitary  conditions 
in  the  villages  and  towns  removed,  so  far  as  possible, 
and  hospital  assistants  with  proper  medicines  were  dis- 
patched to  treat  all  cases." 

Malarial  fevers  were  prevalent  in  many  districts  in 
the  autumn  and  336  packets,  containing  100  doses  of 
quinin  in  each,  were  supplied  to  officials  of  the  govern- 
ment for  free  distribution  to  the  people;  there  was  also 
a  free  distribution  of  quinin  and  other  cinchona  alka- 
loid? from  each  of  the  district  dispensaries. 

The  mortality  from  malaria  was  low,  owing  undoubt- 

1.  Annua!  Report  on  the  .Jaipur  Medical  and  Meteorological  In- 
stitute for   3  903. 


INDIA.  235 

edly  to  tlic  liberal  distribution  of  quiiiiii  free  of  cost 
through  the  different  branches  of  the  government  serv- 
ice. Free  vaccination  is  performed  on  a  very  lajge 
scale,  84,019  cases  during  the  year  covered  by  the  re- 
port. A  very  interesting  account  is  given  of  the  ex- 
perience of  the  medical  officers  in  carrying  out  the 
prophylactic  serum  treatment  (Haffkine)  during  the 
epidemic  of  bubonic  plague,  and  the  prejudice  of  the 
people  against  this  measure  was  only  overcome  by  the 
noble  example  of  one  of  their  chiefs. 

"In  regard  to  inoculation,  the  adoption  of  this  in  the 
early  days  of  the  epidemic  was  most  difficult  and  at  one 
time  apparently  hopeless;  but  patience,  tact  and  moral 
sausion  at  last  overcame  the  dense  ignorance  and  stupid 
prejudices  of  the  villagers.  The  last  argument,  and 
that  which  really  compelled  them  to  give  way  in  the 
end,  was  the  fact  that  their  nazim  stripped  and  bared 
his  body  before  their  eyes  in  order  to  be  inoculated  as 
an  object  lesson.  This  they  would  not  allow,  and  rather 
than  that  he  should  be  a  scapegoat  in  their  behalf,  a 
few  consented.  The  plunge  was  made  and  all  followed 
suit;  before  many  had  been  inoculated  others  clam- 
ored to  be  inoculated  at  once  as  they  could  not  afford 
to  run  the  risk  of  delay  in  waiting  to  be  done  in  their 
proper  order  and  turn,  and  protested  against  others 
being  inoculated  before  themselves.  When  once  they 
saw  and  believed  that  no  harm  and  little  inconveni- 
ence followed  the  inoculation,  they  implicitly  believed 
in  it  and  attributed  to  it  many  virtues  which  it  does  not 
possess  nor  lay  claim  to."  What  a  striking  illustra- 
tion of 

"Men   are  but  children  of  a  larger  growth." — 
Dryden. 

MAYO    HOSPITAL. 

The  Mayo  Hospital,  so  called  in  memory  of  a  former 
governor  of  this  part  of  India,  is  the  government  gen- 
eral hospital  of  Jaipur  and  is  the  largest  of  the  twenty- 
six  hospitals  and  dispensaries  in  the  state  of  Jaipur. 


236  AROUND  THE  AVORLD  VIA  INDIA. 

It  has  a  sui^erb  location,  the  buildings  and  grounds 
facing  the  beautiful  botanical  garden  and  the  fine 
statue  of  the  governor  whose  name  it  conmiemorates. 
The  main  building  is  a  solid  two-story  stone  building, 
and  there  are  a  number  of  one-story  pavilions  of  the 
same  material,  connected  by  roofed  cement  walks  with 
the  central  building.  The  hospital  has  accommodations 
for  160  patients,  all  natives,  cared  for  at  government 
expense.  The  wards  are  capacious,  well  lighted  and 
ventilated,  but  the  furniture  is  scanty  and  of  the  sim- 
plest kind.  The  operating  room  is  small  and  the  ap- 
pliances for  asepsis  of  a  somewhat  primitive  character. 
Lieut.-Col.  Pank  is  at  the  head  of  the  medical  staff, 
assisted  by  several  assistant  surgeons  of  the  subordinate 
Indian  Medical  Service. 

The  worst  feature  of  this  hospital  is  a  lack  of  an 
adequate  number  of  trained  female  nurses.  Most  of 
the  nursing  is  done  by  male  and  female  ward  attend- 
ants, who  receive  at  best  only  the  most  elementary 
training  and,  consequently,  can  not  be  relied  on  in 
the  operating  room  or  in  the  care  of  grave  surgical 
and  medical  cases.  A  training  school  for  female  nurses 
is  a  desideratum  that  should  be  met  without  any  further 
loss  of  time,  as  it  would  be  the  means  of  greatly  facili- 
tating the  work  of  the  medical  officers  and  would  secure 
more  efficient  care  for  the  patients  afflicted  with  grave 
disease  and  for  those  who  are  subjected  to  operative 
treatment.  The  records  of  the  hospital  speak  well  for 
the  surgical  work  of  Lieut.-Col.  Pank,  who  does  most  of 
the  operative  work,  which  includes  general  surgery, 
gA-necolog}^  and  ophthalmology.  Considering  the  diffi- 
culties he  has  to  contend  with,  his  results  compare  well 
with  those  of  other  surgeons  in  India  who  have  better 
assistance  at  their  disposal  and  whose  patients  are  un- 
der the  care  of  competent  trained  female  nurses. 

During  the  year  1903,  24,648  out-patients  and  2,124 
in-patients,  total  26,772.  were  treated  at  the  Mayo 
Hospital.     During  the  same  year  696  major  and  664 


INDIA.  237 

minor,  total  l^JJGO,  operations  weiv  performed;  of  these 
21  per  cent,  were  on  women.  Five  ovarian  cysts  were 
removed  by  ovariotomy  without  a  death — two  of  these 
cysts  were  very  large  and  in  three  cases  the  adhesions 
were  extensive.  Ten  successful  operations  for  tubercu- 
losis of  the  lymphatic  glands  in  the  neck,  axilla  or 
groin  were  performed  and  were  in  many  cases  very 
extensive,  entailing  long  and  careful  dissections.  Thirty- 
seven  operations  on  bones  were  made  without  mor- 
tality. Among  these  were  two  cases  in  which  the  whole 
lower  jaw  was  removed  on  account  of  an  enormous 
epulis;  and  in  three  cases  partial  excision  of  this  bone, 
in  one  case  for  sarcoma  and  in  two  for  necrosis.  The 
right  upper  maxilla  with  malar  and  nasal  bones,  was 
removed  for  sarcoma.  No  death  in  ten  amputations  of 
all  kinds.  Operations  on  the  eye  constitute  the  bulk 
of  the  operative  cases.  Lieut.-Col.  Pank  has  had  an 
enormous  experience  in  operations  for  cataract. 

During  the  year  mentioned  above  239  cataract  opera- 
tions by  von  Graefe's  method  were  performed,  219  by 
Lieut.-Col.  Pank  and  20  by  Assistant-Surgeon  Daljaag 
Singh.  These  operations  were  performed  on  199  per- 
sons; 224  were  recorded  as  able  to  see  well,  4  discharged 
otherwise  and  11  were  under  treatment  at  the  end  of 
the  year.  Artificial  pupils  for  corneal  opacity  were 
made  in  5  cases,  in  3  persons,  and  all  were  useful  in  in- 
creasing vision.  Iridectomy  for  glaucoma  was  per- 
formed in  14  cases  and  the  disorganized  eyeball  was 
extirpated  in  14  cases.  Eight  operations  for  the  radical 
cure  of  inguinal  hernia  by  Bassini's  method  were  suc- 
cessful. In  four  of  these  cases  the  hernia  was  con- 
genital. 

The  rectum  and  anus  were  operated  on  31  times  with 
one  death  (anal  fistula)  ;  14  times  for  hemorrhoids  by 
ligature  and  8  times  for  anal  fistula.  Vesical  calculi 
were  removed  in  43  cases  by  litholapaxy  with  no  death; 
in  3  cases  by  lateral  lithotomy  with  one  death,  and  in 
4  cases  of  perineal  lithotrity  with  no  death.  All  patients 


238  AROUND  THE  WORLD  VIA  INDIA. 

treated  by  litliolapaxy  made  excellent  and  speedy  re- 
coveries. The  largest  stone  removed  by  this  operation 
weighed  935  grains  and  the  average  hospital  life  for 
each  case  was  4.18  days.  The  3  cases  operated  on  by 
lithotomy  were  unfit  for  any  other  operation,  and  the 
patient  who  died  after  operation  was  a  man  worn  out 
by  the  disease  complicated  by  cystitis  and  renal  trouble ; 
his  stone  weighed  1.072  grains.  Perineal  lithotrity 
was  reserved  for  cases  in  which  a  lithotrite  large  enough 
to  crush  the  stone  could  not  be  passed  by  the  urethra. 
The'  operation  was  performed  by  making,  on  a  small 
staff,  a  median  incision  Just  large  enough  to  permit  a 
sufficiently  large  lithotrite  to  enter  the  bladder,  one 
direct  stabbing  incision  going  straight  into  the  blad- 
der on  a  grooved  staff  was  sufficient.  The  largest  stone 
weighed  1,501.5  grains  and  the  average  stay  in  the  hos- 
pital was  12.5  days. 

SPLENIC  ANEMIA. 

In  the  medical  wards  of  this  hospital  I  had  an  op- 
portunity to  examine  four  cases  of  so-called  splenic 
anemia,  that  is,  a  disease  characterized  by  great  en- 
largement of  the  spleen  with  progressive  anemia.  All 
the  patients  were  young  men,  natives,  from  18  to  35 
years  of  age.  In  all  the  abdomen  was  very  much  en- 
larged and  pendulous,  and  through  the  thin  abdominal 
walls  the  outlines  of  the  enormously  enlarged  spleen 
could  be  very  plainly  traced.  In  some  of  those  cases  the 
spleen  extended  beyond  the  median  line  and  its  lower 
border  almost  reached  the  level  of  Poupart's  ligament. 
In  two  of  the  cases  the  liver  was  also  markedly  en- 
larged. Emaciation  and  a  profound  anemia  in  all  of 
them  were  the  most  prominent  clinical  features.  I 
was  informed  that  this  disease  generally  yields  in  the 
course  of  time  to  a  sulphate  mixture  Avhich  is  used  in 
this  hospital,  of  which  the  most  active  ingredients  are 
sulphate  of  quinin  and  sulphate  of  iron. 

During  my  visit  to  the  Bengal  Medical  College,  Cal- 


INDIA.  239 

ciitta,  Capt.  Seward  Rogers,  I. M.S.,  professor  of  patli- 
ology,  was  kind  enough  to  show  me  imder  the  micro- 
scope the  parasite  which  has  been  shown  to  be  the  cause 
of  this  strange  disease.  It  was  discovered  by  Leish- 
man  and  Donovan,  and  has  been  classified  by  Laveran 
and  Mesnil  under  the  name  of 

FIROPLASMA   DONOVANI. 

This  newly  discovered  parasite  has  attracted  a  great 
deal  of  attention,  and  among  the  numerous  articles  de- 
scriptive of  it  I  will  only  refer  to  the  article  on  Piro- 
plasmosis  by  Captain  Donovan,  published  in  the  '"An- 
nual Report  and  Statistics  of  the  Government  General 
Hospital  Madras,  for  the  Year  1903."  And  a  very  im- 
portant monograph,  "A  Preliminary  Report  on  a  Para- 
site Found  in  Persons  Suffering  from  Enlargement  of 
the  Spleen*  in  India,"  by  Lieut.  S.  R.  Christophers, 
M.B.,  T.S.M.,  a  government  publication. 

Captain  Donovan,  in  the  article  referred  to,  gives  a 
short  history  of  his  discovery,  from  wdiich  I  will  give 
here  some  extracts.  In  speaking  of  piroplasmosis  he 
says :  "Under  tliis  head  I  have  classified  a  neAv  disease 
prevalent  in  Madras;  the  symptoms  are  those  of  so- 
called  chronic  malaria.  ...  I  had  noticed  many 
cases  of  chronic  irregular  pyrexia,  with  enlargement  of 
the  spleen,  and  occasionally  of  the  liver,  broncliiti/5, 
edema  of  the  feet,  subcutaneous  hemorrhages,  chiefly 
of  the  petechial  type,  diarrhea  of  a  dysenteric  nature 
and  cancnun  oris.  The  treatment  was  most  imsatis- 
factory,  no  drug  having  the  least  beneficial  effect." 

Captain  Donovan  doubted  the  malarial  character  of 
the  disease  and  at  once  made  a  thorough  examination 
of  postmortem  specimens.  "With  a  view  to  remove 
this  doubt  I  attended  the  postmortems  and  took  smears 
of  blood  from  the  spleens  of  patients  said  to  have  died 
of  chronic  malaria.  On  the  first  day,  April  9,  1903,  I 
found,  in  a  slide  containing  such  a  stmear,  numerous 
peculiar  round   and  oval  ring-like  little  bodiess,   with 


240  AROUND  THE  WORLD  VIA  INDIA. 

two  masses  of  chromatin  situated  in  opposite  poles. 
Convinced  as  I  was  of  their  parasitic  nature,  I  could 
not.  however,  refer  them  to  any  group  of  protozoa.  I 
thought  I  had  discovered  the  long-sought-for  resting 
stage  form  of  the  malarial  parasite  in  man,  but  on  per- 
ceiving the  same  bodies  in  two  other  cases  on  April  33 
and  24,  1903,  I  changed  my  view  and  considered  that 
thev  might  be  postmortem  degenerations  of  the  nuclei 
of  the  splenic  pulp  cells.  On  June  15,  1903,  I  received 
the  British  Medical  Journal  of  May  30,  of  the  same 
year,  and  in  it,  on  page  1,252,  was  an  account  by  Major 
Leishman.  E.A.M.C.,  of  organisms  identical  with  mine. 
I  at  once  recognized  the  similarity  of  what  Leislunan 
called  degenerations  of  the  trypanosomata,  to  the  bodies 
found  by  me  in  the  spleen  blood  of  the  three  cadavers 
above  mentioned." 

On  June  17.  1903,  Captain  Donovan  punctured  the 
spleen  of  a  boy  suffering  from  this  type  of  fever  and 
fomid  in  it  bodies  identical  with  those  fomid  post- 
mortem. The  results  of  tliis  examination  were  pub- 
lished in  the  British  Medical  Journal,  July  12,  the  saine 
year.  On  September  23  he  sent  a  slide  containing 
these  bodies  to  the  Pasteur  Institute,  where  they  were 
carefully  examined  by  Laveran  and  MesnJl  and  named 
in  honor  of  their  discoverer  Piroplasma  donovani. 

A  large  clinical  experience  has  demonstrated  the 
direct  etiologic  relationship  of  tliis  parasite  with  the 
splenic  affection  in  question.  The  parasite  is  not  found 
in  the  peripheral  blood  and,  for  diagnos,tic  purposes, 
blood  has  to  be  obtained  from  the  spleen  by  puncturing 
it.  It  is  in  this  organ  that  the  micro-organism  is  foimd 
in  gTeatest  abundance.  Puncture  of  the  spleen  for 
diag-nostic  purposes  is  not  entirely  devoid  of  danger; 
there  is,  at  least,  one  case  on  record  in  which  the  punc- 
ture gave  rise  to  fatal  internal  hemorrhage  (Donovan, 
Case  24).  The  presence  of  this  parasite  in  the  splenic 
blood  furnishes  absolute  proof  of  the  nature  of  the 
splenic  enlargement  and  settles  the  differential  diagno- 


INDIA.  241 

sis  betw'cen  tliis  disease  and  malarial  and  leukemic 
enlargement  of  the  spleen.  In  the  paper  quoted  above 
Captain  Donovan  gives  a  detailed  account  of  31  cases 
tiha.t  came  under  his  personal  observation  during  one 
year  with  many  postmortem  findings. 

Captain  Donovan  describes  the  clinical  features  of 
this  disease  as  follows:  "The  symptoms  are,  in  typical 
cases,  an  irregular  pyrexia  of  two  or  three  months' 
duration,  accompanied  with  shivering  with  apyrexial 
intervals.  About  this  time  the  spleen  becomes  enlarged 
and  painful,  and  edema  of  the  feet  begins;  there  is 
usually  diarrhea  of  a  dysenteric  nature,  which  comes  and 
goes  for  a  week  or  so  at  a  time.  Ijater  the  lungs  are 
affected;  there  is  cough  and  expectoration,  enlargement 
of  tlie  liver,  ascites'  (unusual)  ;  subcutaneous  hem- 
orrhages of  a  petechial  nature;  soreness  of  the  mouth, 
giuns  or  hard  palate  and  cancrum  oris.  Marked  eiuaeia.- 
tion  and  anemia  supervene,  the  skin  becomes  dry  and 
furfuraceous  and.  if  the  patient  is  not  washed,  the  skin 
takes  on  a  dark  discoloration.  .  .  .  The  blood  ex- 
amination, in  cases  of  piroplasma  infection,  always 
shows  a  marked  decrease  of  the  red  globules;  tliese  vary 
from  two  to  three  millions  to  the  cubic  millimeter. 
There  is  no  actual  increase  of  the  leucocytes,  but  a  rela- 
ive  one  of  the  mononuclears,  as  in  malaria.  The  urine 
usually  contains  albumin  and  invariably  pigment,  uro- 
bilin. The  feces  in  some  cases  contain  balantidia, 
ankylostoma  and  rhabdonemata.  Quinin  has  been  given 
by  mouth,  hypodermically  and  intramuscularly  ad  nau- 
seam, with  no  appreciable  result.  The  same  may  be 
said  of  other  les,s  suitable  drugs,  i.  e.,  arsenic,  salicylate 
of  sodium,  carbolic  acid,  etc.^' 

I  will  give  here  as  an  illustration  the  findings  of  only 
one  postmortem  examination:  "Case  30.  Eaghavan, 
aged  30  years,  lived  at  Periyamet,t.  Fever  irregularly 
for  a  month  and  a  half;  spleen  enlargement  noticed  a 
month  ago ;  during  this  period  he  had  occasional  attacks 
of  diarrhea  and  soreness  of  the  mouth.     Admitted  for 


243  AROUND  THE  WORLD  VIA  INDIA. 

diarrhea  and  distension  of  the  abdomen;  his  spleen  and 
liver  were  enlarged  and  he  had  edema  of  the  feet.  He 
died  on  the  fourth  day  after  admission.  The  postmor- 
tem was  made  by  Captain  Symons,  I.M.S.,  and  the 
following  notes  were  recorded :  Considerable  amonnt  of 
clear  fluid  with  floating  lymph  in  abdomen;  colon  at 
splenic  flexure  gangrenous;  transverse  colon  much 
thickened — almost  half  an  inch  in  places  and  ulcerated, 
containing  raised  papillae  on  the  mucous  surface  of  a 
bright  red  color;  descending  colon  a  dark  gray  color; 
spleen  much  enlarged  with  pigment  in  patches;  liver 
much  enlarged.^^ 

The  Piroplasma  donovani  is  found  free  in  the  splenic 
blood  and  as  a  cell  inclusion  in  the  red  corpuscles  and 
macrophages,  but  more  frequently  in  tlie  leucocytes; 
in  some  of  the  cells  it  is  multiple.  (Clu-istophers.") 
(Fig.  47.) 

Tjieut.  S.  R.  Chxistophers,  in  his  exhaustive  mono- 
graph on  this  parasite,  gives  a  very  minute  description 
of  its  morphology  and  multiplication  by  flssion.  'Tn 
films  stained  by  Eomanowsky's  method  the  bodies  are 
seen  with  great  clearness.  They  exhibit  a  remarkable 
uniformity  in  size  and  appearance.  The  majority  are 
about  2.5  micromillimeters  in  diameter,  but  forms  may 
be  found  which  are  a  little  larger,  3  to  3.5  micromil- 
limeters, or  a  little  smaller.  Very  occasionally  still 
smaller  bodies,  1.5  micromillimeters  in  diameter,  may 
be  encountered.  Most  of  the  bodies  are  approximately 
circular  in  outline,  but  very  man}^,  especially  the  larger 
forms,  are  irregularly  oval  and  very  much  resemble  a 
cockle-shell  in  shape.  This,  indeed,  appears  to  lie  the 
most  typical  shape,  and  even  in  the  apparently  round 
forms  an  approach  to  this  shape  can  be  made  out.  Oc- 
casionally specimens  are  found  more  elongated  and  dis- 
tinctly pear-shaped.  .  .  .  Except  in  very  rare  small 
forms  which  show  only  a  single  chromatin  mass,  the 
bodies  invariably  possess  two  chromatin  masses — a  large 


(P 

Fig  6. 

P.P. 15. 


Fip.7. 


Tip.  15. 


f»    S 


Fip.8. 


F,^.9, 


F,g.lO. 


F.gl7. 


F.-i^'.l3. 


^     'v^ 


.  ■*'., 


Fip.ZI. 


4   >         t» 


Fid, 22. 


sj 


*^  JH 


Ftp  27. 


?r, 


V    * 


F(^.28: 


Fig.  47. — riroplasiua  Donovani. 


INDIA,  245 

one  staining  lightly  and  a  small  one  staining  intensely, 
with  tlio  red  coloring  matter  of  Romanowsky's  stain. 

"The  two  chromatin  masses  are  nsually  situated  oppo- 
site to  each  other  in  the  shorter  axis  of  the  parasite. 
The  large  chromatin  mass  is  situated  near 
what  would  be  the  hinge  in  tlie  cockle-shell-shaped 
forms  and  in  tlie  thicker  end  of  the  pear-shaped  forms. 
The  body  substance  usually  stains  pink  l)y  the  method 
employed  (fixation  in  alcohol  and  staining  by  watery 
solutions  of  eosin  and  Eomanowsky's  blue) .... 
Forms  may  be  seen  which  appear  to  show  division  of 
the  bodies  into  two.  Appearances  showing  both  longi- 
tndinal  and  transverse  fission  are  seen.  In  the  former 
two  pear-shaped  bodies  are  found  lying  side  by  side. 
The  larger  chromatin  masses  are  situated  in  the  thick 
end  of  the  pear  and  the  small  red  bodies  at  the  thinner 
end,  and  thie  small  chromatin  mass  may  often  be  seen 
undivided  when  the  larger  masses  are  widely  separated." 

The  discovery  of  the  real  parasitic  cause  of  splenic 
enlargement  and  anemia,  such  a  common  and  very  fatal 
disease  in  India,  will,  it  is  to  be  hoped,  soon  lead  the 
way  to  a  more  successful  treatment. 

The  work  done  in  this,  one  of  the  newest  fields  in 
pathology  and  bacteriolog}^,  b}^  the  oflficers  of  the  Indian 
Medical  Service  reflects  great  credit  on  that  branch 
of  the  British  colonial  service  and"  will  undoubtedly 
serve  as  a  stimulant  to  others  to  blaze  new  pathw^ays  in 
the  as  yet  but  imperfectly  explored  wilderness  of  tropie 
diseases,  tropic  medicine  and  tropic  surgery. 

BiiiXDisi,  Italy,  Sept.  30,  1904. 


GRANT  MEDICAL  COLLEGE  AND  THE  HOSPI- 
TALS OF  BOMBAY. 


Bombay,  with  its  800,000  inhabitants,  is  tlie  com- 
mercial metropolis  and  medical  center  of  India.  The 
citv  has  many  and  varied  medical  institutions  that 
awaken  the  interest  of  the  professional  visitor.  The 
most  important  among  these  is  the  Grant  Medical  Col- 
lege, the  largest  medical  school  in  India.  For  sixty 
vears  it  has  been  the  Mecca  for  native  yonng  men  in 
that  part  of  India  who  were  desirous  of  entering  the 
rallies  of  the  medical  profession.  Thousand,s  of  grad- 
uates have  left  its  doors  well  prepared  to  serve  their 
coimtrymen  as  reliable  and  competent  physicians.  From 
a  modest  beginning  it  has  developed  into  a  great  med- 
ical school  with  an  attendance  of  more  than  600.  The 
personnel  of  the  students  is  an  interesting  one.  The 
mixture  of  colors,  from  the  almost  pure  white  of  some 
of  the  Eurasians  to  the  coal  black  of  some  of  the  Hindus, 
and  the  variety  in  dress,  from  Parisian  to  the  most 
picturesque  costumes  makes  up  an  interesting  picture 
for  the  foreigner. 

The  Mohammedan  population  of  India  is  large  but, 
as  a  rule,  its  young  men  manifest  little  desire  for  a 
hiffher  education  and  the  number  of  medical  students 
from  this  source  is  small.  On  the  other  hand,  the 
Hindus  take  kindly  to  the  professions  of  law  and  med- 
icine and  the  bulk  of  the  medical  students  is  recruited 
from  thte  high  ca.ste  Hindus.  The  Parsee  element  of 
the  population  is  well  represented  in  the  medical  schools, 
and  the  strange  headdress  of  the  males  of  these  people 
figures  conspicuously  in  all  the  classrooms.    (Fig.  48.) 

The  female  medical  students  number  about  sixty  and, 
with  the  exception  of  two  or  three  white  women,  they 
are  Hindus,  Parsees  and  Eurasians.     What  are  known 


248  AROUND    THE    AVORLD    VIA    INDIA. 

a^  half-castes  in  Ceylon  are  designated  in  India  by  the 
more  euphonious  word,  Eurasians,  meaning  a  mixture 
of  Europeans  with.  Asiatics..  The  female  medical  stu- 
dents have  won  for  themselves  here,  as  elsewhere,  an 
enviable  reputation  as  enthusiastic,  hard  workers,  who, 
when  the  time  for  graduation  comes,  are  never  found 
at  the  undesirable  end  of  the  class.  Their  subsequent 
professional  career  is  often,  however,  a  very  checkered 
one.  Some  receive  hospital  positions  with  small  sal- 
aries, rupees  100  to  .200  ($32  to  $64)  a  month;  others 
enter  private  practice,  but  seldom  meet  with  great  suc- 
cess; some  marry,  and  not  a  small  percentage  sooner 
or  later  abandon  their  profession  and  turn  their  atten- 
tion to  some  other  more  lucrative  vocation. 

The  professors  are  selected  from  the  Indian  Medical 
Ser\dce  with  special  reference  to  their  aptitude  to  teach 
the  different  branches.  The  principal  chairs,  medicine, 
surgery  and  obstetrics,  are  occupied  by  men  who  have 
had  an  extensive  experience,  wdiile  the  primary  branches, 
especially  pathology  and  bacteriology,  are  usually 
taught  by  the  younger  members  of  the  service.  J^ative 
graduates  hold  subordinate  positions  in  tlie  teaching 
force  as  assistant  professors,  instructors,  demonstra- 
tors, tutors,  etc.  The  professors  whO'  belong  to  the 
civil  branch  of  the  Indian  Medical  Service  receive  a 
salary  according  to  their  military  rank  and  in  addition 
they  receive  some  remuneration  from  the  college  for 
their  services  so  that,  for  instance,  a  lieutenant  colonel 
who  has  been  in  the  service  for  20  years  may  have  an 
annual  income  of  $4,800.  In  the  event  of  his  death, 
his  widow  receives  a  pension  of  $750  a  year  and  each 
of  his  children  $150  a  year,  the  sons  until  they  reach 
the  age  of  21  years  and  the  daughters  until  they  become 
married.  The  pensions  are  provided  by  a  fund  to 
which  each  officer  contributes.  When  an  officer  gets 
married  he  pays  into  this  fimd  2,000  rupees  ($640), 
and  1,000  rupees  ($320)  after  the  birth  of  every  cliild. 
At  the  end  of  25  years,  on  retiring,  he  receives  a  pen- 


Fig.    4S. — A    Pai-see. 


INDIA. 


251 


sion  of  .$-i, .■)()()  a  year.  Tlie  teacliing  duties  of  thc'^e 
iiu'ii  arr  so  exacting  that  they  are  given  but  a  slight 
chance  to  increase  their  income  by  private  practice, 
uh'cl)   is.  however,  permitted, 

Tlic  original  Grant  Medical  College,  so  called  in 
honor  of  one  of  the  former  governors  of  Bombay,  is  a 
substantial,  venerable,  two-story  stone  building.  With 
the  increasing  d(Mnand  for  space,  additional  buildings 
have  Ix'on  erected.  The  anatomy  building  (Fig.  49). 
now  nearing  completion,  is  a  two-story,  massive  stone 


Fig.  4;i. — Anatomy   LUiikliug.  Grant  Medical  College. 

building,  with  marble  floors;  the  upper  story  is  the 
dissecting  room,  which  is  flooded  with  light  from  all 
directions.  It  is  unquestionably  the  finest  dissecting 
room  in  the  world.  Connected  with  it  is  a  small  sep- 
arate building,  covered  with  wire  screen  for  the  purpose 
of  excluding  vultures  and  crows,  in  Avhicli  the  bodies 
are  prepared  and  the  bones  of  the  dissected  sul^jects  are 
cleaned  and  mounted. 

The  chemical  and  pathologic  laboratories  are  inade- 
quate for  the  present  requirements  and  it  is  hoped  that 
separate  buildings  will  soon  be  erected  for  each  of  these 
very  important  primary  branches.     With  an  ever  in- 


252  AROUN^D  THE  ATORLD  VIA  INDIA. 

creasing  attendance,  the  lecture  rooms  will  also  soon 
become  too  small.  The  curriculum  of  study  for  ilie 
M.B.  and  B.S.  degrees  extends  over  five  years  and  in- 
cludes the  following  studies : 

First  Year. — Biologv',  botany,  cluemistry,  practical 
chemistry,  materia  medica,  practical  pharmacy. 

Second  Year. — Anatomy,  botany,  chemistry,  practical 
chemistry,  materia  medica,  practical  pharmacy,  phy- 
siolog}'. 

Third  Year. — Physiology-,  histology  and  practical 
physiology,  anatomy. 

Fourth  Year. — Medicine,  surgery,  pathology,  hygiene, 
diseases  of  women  and  children,  demonstrations  in 
patholog}^  clinical  practice  in  medical,  surgical  and 
obstetric  wards.  Attendance  at  male  and  female  out- 
patient rooms.    Attendance  at  pathologic  room. 

Fifth  Year. — Surgery,  medicine,  diseases  of  women 
and  cliildren,  operative  surgery,  clinical  practice  in 
medical,  surgical,  obstetric  and  surgical  wards,  attend- 
ance at  pathologic  room. 

A  glance  at  the  curriculum  shows  what  attention  is 
paid  to  tlie  primary  branches,  especially  chemistry,  anat- 
omy and  botany,  the  last  of  these  entirely  ignored  in 
most  of  our  medical  colleges  and  the  first  and  second 
only  too  often  treated  in  a  stepmotherly  way.  The 
students  are  not  pestered  with  unnecessarily  frequent 
examinations,  as  only  two  examinations  a  year  are 
held,  at  the  end  of  each  semiannual  term. 

The  militarj^  pupils,  of  whom  there  are  now  <S6  in 
attendance  and  who  finish  their  studies  in  four  years, 
have  a  somewhat  different  curriculum  of  study  to  fol- 
low.    It  is  as  follows: 

First  Year. — Anatomy,  descriptive  and  surgical,  dis- 
sections, anatomy  and  physiology,  materia  medica, 
chemistry  and  practical  chemistry,  compounding  dis- 
pensary. 

Second   Year. — Anatomy,  descriptive    and    surgical. 


INDIA.  253 

dissections,  anatomy  and  physiology,  materia  mcdica, 
chemistry  and  practical  chemistry,  compounding-  dis- 
pensary. . ,  :     . 

Third  Year. — Medicine  and  clinical  medicine,  sur- 
gery and  clinical  surgery,  diseases  of  women  and  chil- 
dren, hygiene,  pathology,  hospital  practice  and  out-door 
dispensaries,  postmortem  examinations. 

Fourth  Year. — ^ledicine  and  clinical  medicine,  sur- 
gery, clinical  and  operative  surgery,  diseases  of  women 
and  children,  practical  toxicology,  clinical,  medical,  sur- 
gical, ohstetrical,  and  ophthalmic  wards. 

Fourth  year  students  and  third  year  military  pupils 
attend  in  rotation  at  the  male  out-patient  rooms  as  ar- 
ranged hy  their  teachers.  Female  pupils  attend  at 
the  female  out-patient  rooms.  Four  and  five  didactic 
lectures,  from  10  to  3  or  4  p.  m.,  are  delivered  daily 
except  Saturday,  on  which  day  only  two  lectures  are 
given,  during  the  forenoon.  The  clinics  in  the  Jam- 
setjee  Jeejeebhoy  Hospital  begin  at  7  or  7 :30  a.  m. 
and  are  held  daily.  This  is  the  hospital  in  which  the 
clinical  teaching  in  medicine  and  surgery  is  done  exclu- 
sively. The  present  teaching  staff  consists  of  eleven 
professors,  one  demonstrator  and  eleven  tutors.  Lieut.- 
Col.  H.  P.  Dimmock,  I.M.S.,  is  principal  of  the  school 
and  professor  of  obstetrics,  gynecology  and  diseases  of 
children,  and  Lieut.-Col.  Quicke,  I.M.S.,  is  professor  of 
surgery,  operative  surgery  and  surgical  anatomy. 

The  final  examination  in  this  college  appears  to  be 
quite  a  severe  one,  as  every  year  only  about  45  per  cent, 
of  the  candidates  for  graduation  are  recommended  to 
the  Bombay  University,  with  which  the  college  is  af- 
filiated, for  the  degree.  Those  who  fail  may  come  up 
again  for  examination  at  the  close  of  the  next  or  of 
any  other  subsequent  term. 

The  military  pupils  are  prepared  for  the  assistant 
surgeon  branch  of  the  Indian  Subordinate  Medical  De- 
partment. They  must  be  of  European  or  Eurasian 
parentage,  not  less  than  16  and  not  more  than  18  years 


254  AROUND    THE    WORLD   VIA    INDIA. 

of  age.  They  must  pass  a  satisfactory  physical  exam- 
ination and  are  examined  in  the  following  subjects: 
English,  handwriting,  dictation,  composition,  explana- 
tion of  idioms  and  grammar  questions.  History  and 
geography — The  outlines  of  English  and  Indian  his- 
tory, and  the  elements  of  physical  and  general  geog- 
raphy. Mathematics — Arithmetic:  The  four  simple 
rules,  vulgar  and  decimal  fractions,  reduction,  practice, 
proportion,  simple  interest,  extraction  of  square  root. 
Algebra:  The  four  simple  rules,  proportions,  simple 
equations;  Euclid,  first  book.  Vernacular — Hindustani, 
colloquial. 

They  ai'e  educated  at  government  expense.  Pupils 
who  obtain  less  than  33  per  cent,  of  marks  in  each  sub- 
ject of  their  final  examination  will  be  liable  to  removal 
from  tlie  college.  Such  pupils,  however,  will  be  allowed 
to  remain  for  a  further  period  (to  be  fixed  1)y  the  prin- 
cipal in  each  case)  in  the  college  to  continue  their  studies 
at  their  own  expense.  ]\Iilitary  assistant  surgeon  grad- 
uates from  this  department  of  the  college  are  employed 
in  hospitals  of  British  troops  and  in  military  and  civil 
appointments;  those  in  civil  employment  being  available 
for  military  duty  in  time  of  war  or  other  urgent  neces- 
sity. This  l)ranch  of  the  military  medical  service  is 
entitled  to  the  following  pay: 

1.  Senior  assistant  surgeon,  with  honorary  rank  of 
captain.  400  rupees  ($128). 

2.  Senior  assistant  surgeon,  with  honorary  rank  of 
.lieutenant,  300  rupees  ($96). 

3.  Asistant  surgeon,  first  class,  200  rupees  ($64). 

4.  Assistant  surgeon,  second  class,  150  rupees  ($4S). 

5.  Assistant  surgeon,  third  class,  110  rupees  ($35.20). 
G.  Assistant  surgeon,  fourth  class,  85  rupees  ($27.20)  ■ 
In  addition  to  this  pay  they  receive  allowances  when 

on  special  duty,  and  traveling  expenses,  and  pensions 
on  retiring  from  the  service,  l^etirement  is  compulsory 
at  tlie  age  of  55  vears. 


INDIA.  355 

PATHOLOGIC  MUSEUM, 

The  pathologic  museiini  of  Grant  Medical  College 
contains  a  very  large  amount  of  material  illustrative 
of  tropical  diseases.  It  is  the  ro^^ult  of  accumulation 
of  specimens  for  60  years  and  should  contain  more  than 
it  does,  but  the  opposition  to  postmortem  examinations 
is  so  violent  and  persistent  that  permission  is  only 
seldom  obtained.  No  Parsee  corpse  has  ever  been 
touched  by  a  pathologist  except  imder  medico-legal 
pressure.  Not  many  years  ago  a  postmortem  was  made 
on  a  Mohammedan  and  when  tlie  fact  became  loiown  it 
gave  rise  to  a  liot  in  the  hospital  groimds,  which  it 
was  found  difficult  to  suppress.  Since  that  time  the 
Mohammedans  employ  a  salaried  guard,  who  watches 
the  approach  of  grim  death  in  the  hospital,  and,  if  the 
patient  is  a  Mohammedan,  he  sees  to  it  tliat  the  corpse 
escapes  the  postmortem  knife.  The  Hindus  furnish  the 
material  for  the  museum  almost  exclusively. 

This  unreasonable  objection  to  postmortem  examina- 
tions by  a  large  proportion  of  the  population  of  Bom- 
bay has  seriously  interfered  in  collecting  a  larger  ma- 
terial. A  catalogue  of  specimens  in  the  Pathologic  Mu- 
seum was  prepared  by  Capt.  G-.  P.  G-ordon,  I.M.S.,  in 
1903,  and  was  published  by  the  government  in  the  form 
of  a  well  bound  and  well  printed  book  of  247  pages. 
I  will  quote  here  a  description  of  only  a  few  of  the  most 
interesting  specimens': 

Pneumonic  Plague. — The  lung  is  solid  throughout, 
greatly  enlarged,  and  the  visceral  pleura  covered  with 
slate-colored  blotches,  which  are  subserous  hemorrhages. 
This  specimen  was  from  a  patient  aged  26,  who  was  ill 
about  three  days.  One  section  of  the  lung  was  filled 
with  light  colored  masses,  which  were  surrounded  by 
areas  of  acute  congestion.  The  lower  were  more  mark- 
edly affected  by  consolidation  than  the  upper  lobe. 
There  were  several  hemorrhages  in  the  cellular  tissue  of 
the  posterior  mediastinum,  and  the  other  viscera  were 
acutelv  congested. 


256  AROUND    THE    WORLD   VIA    INDIA. 

Syphilitic  Fibrosis  of  the  Lung. — A  portion  of  the 
left  lower  lobe,  showing  broad  bands  of  fibrous  tissue 
running  through  it,  the  larg&st  proceeding  from  the 
base  of  the  lung  in  an  upward  direction.  The  section 
shows  very  little  lung  parenchyma,  and  that  in  a  most 
condensed  state.  I^umerous  openings  of  vessels  and 
dilated  bronchi  are  seen,  closely  agglomerated  from  the 
shrinlving  process  which  has  gone  on.  The  affected 
portion  of  the  lung  seems  to  be  shut  off  from  tlie  more 
healthy  part  by  a  broad  band  of  fibrous  tissue.  The 
specimen  was  taken  from  a  man  who;9e  leg  was  ampu- 
tated for  chronic  ulceration;  a  Hindu  aged  40  years. 
There  were  a  few  caseous  nodules  in  the  right  lung; 
the  capsules  of  the  liver  and  spleen  are  greatly  thickened, 
especially  of  the  latter.  There  was  a  gumma  in  the 
spleen;  both  testicles  had  undergone  fibroid  degenera- 
tion with  thickening  of  the  tunica  vaginalis.  There 
was  a  left  hydrocele. 

Aneurism  of  the  Heart. — At  the  upper  posterior  part 
of  the  left  ventricle,  immediately  to  the  right  of  the 
mitral  valve,  is  a  pouched  condition  of  the  septum 
m^easuring  fully  1^4  inches  across  at  its  mouth  and  an 
inch  deep  at  the  deepest  part.  The  pouch  is  lined  with 
thick,  opaque  endocardium.  The  right  group  of  chordae 
tendinese  is  thickened.  There  is  thickening  and  con- 
traction of  the  mitral  orifice.  In  the  right  ventricle 
is  a  patch  of  opaque  endocardium  at  a  point  covering 
thfe  pouch  in  the  septum.  The  patient  was  a  male 
Mohammedan,  aged  60;  ill  for  weeks.  The  aorta  was 
atheromatous,  a  breaking  down  gumma  was  found  in 
the  liver,  the  capsule  of  which  was  extensively  scarred. 
The  right  kidney  was  atrophied  and  contained  sand- 
like calculi;  left  kidney  hypertrophied ;  fibroid  left  tes- 
ticle; ulceration  of  large  intestine.  It  is  suggested 
that  it  is  a  case  of  syphilitic  myocarditis,  with  resulting 
fibroid  degeneration  causing  weakening  of  the  septimi. 

Malarial  Hepatitis. — Section  of  a  liighly  pigmented 
liver,  which  is  hard  and  has  a  mottled  appearance  on 


INDIA. 


257 


tlio  surface.  The  suil'aee  of  tlie  section  i~  ui'aiuhar. 
Such  livers  are,  as  a  rule,  slightly  enlarged,  miii'ornily 
tender,  associated  with  slight  jaundice,  some  evidence 
of  bronchitis  at  the  base  of  the  right  lung,  and  there- 
fore they  are  often  difficult  to  distinguish  froni  eases 
of  hepatic  abscess. 

Hepatic  Abscess. — This  sIioavs  the  iippei-  surface  of 
the  liver.  wher6  an  abscess  liad  burst  through  the  dia- 
phragm.    There  were  three  large  abscesses  in  the  right 


Fig.  50. — Madura  foot.     Amputation  by  Professor  Quicke. 

lobe.  One  had  intricate  connection,  with  the  diaphragm, 
which  formed  the  upper  wall  of  the  abscess  cavit\^  In 
this  were  two  minute  perforations,  which  communicate 
through  the  thickened  pleura,  with  a  pneumonic  patch 
in  the  base  of  the  right  lung.  The  patient  was  a  Mus- 
sulman, aged  28.  The  illness  commenced  with  an 
attack  of  dysentery,  three  months  prior  to  admission. 
]^o  signs  of  dysenteric  ulcerations  were  found  in  the 
b)Owel  at  the  posmortem  examination. 

Enormous  Calcuhis  of  the  Bladder. — This  stone  (uric 


258  AROUND  THE  WORLD  VIA  INDIA. 

acid  and  urate?)  is  probably  one  of  the  largest  stones 
ever  removed  from  the  human  bladder.  About  half 
of  the  stone  is  shown  in  the  central  compartment  and 
the  fragments  are  grouped  around  it.  The  operation 
in  this  case  was  performed  in  1876  or  1877  by  the  late 
Apothecary  White  at  Tando  Alyhar  Dispensary,  near 
Hyderabad,  in  Sinde.  The  patient  was  a  man  25  years 
old  and  had  suffered  from  symptoms  of  stone  since 
chiklhood.  An  attempt  was  made  to  extract  it  by  the 
lateral  operation,  but  this  being  unsuccessful,  the  supra- 
pul>'c  operation  was  performed.  Even  now  it  was  found 
impossible  to  extract  the  stone.  By  means  of  some 
improvised  instrument  (a  craniotomy  forceps),  the 
stone  was  broken  in  pieces  and  removed.  The  patient 
lived  for  about  twelve  hours  after  the  operation.  The 
weight  of  the  stoue  was  30  ounces  and  95  grains. 

Ainlium  of  the  Small  Toe. — This  curious  condition 
generally  commences  on  the  inner  and  plantar  surface 
of  tbe  little  toe.  It  begins  as  a  narrow  groove  on  the 
skin,  which  slowly  deepens.  The  groove  involves  the 
whole  circumference  of  the  digit,  the  distal  portion  of 
which  swells  up  as  if  it  had  been  constricted  by  a  liga- 
ture. TJie  digital  portion  finally  becomes  a  round, 
dangling  mass  and  after  some  years  drops  off.  The 
fourth  toe  is  next  affected,  and  so  on. 

Mycetoma  or  Madura  Foot. — The  shape  of  the  foot 
is  characteristic  (Fig.  50).  The  disease  is  absolutely 
localized  to  the  foot,  the  circumference  of  the  leg  above 
the  ankle  not  being  increa'^ed.  The  skin  of  the  foot  is 
covered  with  pellets,  some  of  which  have  been  cut  across 
to  show  the  yellow  fatty  material  of  which  they  are 
composed.  A  window  bas  l>een  cut  on  one  side  of  the 
foot.  A  capsule  of  thick,  dense,  fibrous  tissue  envelopes 
the  foot  and  this  hardened  tissue  is  honeycombed  with 
small  cavities,  which  lodge  the  yellow  bodies  in  the 
interior  of  the  bone,  which  has  fallen  away  from  the 
tissues  and  which  can  be  seen  riddled  with  large  com- 
municating cavities.      The  specimen   was   obtained    by 


IXDIA. 


259 


aiii[)Ul;it  inn  and   in'csciitcil  to  the  iiiiisciim  hy  tlic  opi'ra- 
tor.  Professor  C^uicke  (Fig.  JO). 

Anesthetic  Leprosy. — A  disseetidu  of  a  lo[)i'ous  foot 
made  by  the  late  Dr.  Van  Dyke  Carter.  The  nerves 
are  considerably  thickened,  especially  on  the  plantar 
surface.  The  great  toe  ha.s  been  lost,  and  all  the  digits, 
except  tlie  middle  one,  are  partially  absorbed. 


Fig.  51. — KeToid  of  puuctured  lobe  of  ear.      P^xcision.     with 
cosmetic   results,    by   I'l'ofessor  Qnlclce. 


Guinea  Worm. — This  is  a  long,  thin  worm  from  13 
to  40  inches  long.  The  female  only  is  known  as  a 
parasite  in  the  hunjan  body.  It  wanders  into'  the  loose 
subcutaneous  tissues  of  the  leg.  scrotum  and  sometimes 
the  upper  limb,  and  there  generally  forms  an  abscess 
or  it  may  form  a  vesicle  from  which  the  extremity  pro- 
jects, when  it  can  l)e  gradually  removed  l)y  slow  trac- 


2G0  AUOUXD  THE  WORLD  VIA   INDIA. 

tion  extending  over  some  days,  the  protruded,  portion 
being  wound  round  a  stick.  ■  ■  . 

Jamsetjee  Jeejeehhoy  Hospital. — The  Jamsetjec  Jee- 
jeeblioy  is  one  of  the  oldest  and  best  known  of  the  many 
Bombay  hospitals.  It  bears  the  name  of  the  Parsee 
who  built  it  at  his  expense  and  presented  it  to  the  gov- 
ernment in  1845,  the  same  year  that  Grant  Medical 
College  opened  its  doors  to  medical  students.  Mr.  Jam- 
setjee Jeejeebhoy  was  a  poor  man,  but  made  a  fortune 
by  buying  and  selling  bottles  nearly  a  century  ago, 
hence  the  hospital  is  still  well  known  nnder  the  name 
of  "Bottle  Hospiital."  Mr.  Jamsetjee  Jeejeebhoy  was 
Imighted  by  Queen  Victoria  in  recognition  of  his  many 
deeds  of  charity,  and  a  full  sized  statue  of  stone  in  a 
half  reclining  position  in  the  main  entrance  hall  Oif 
the  hospital  does  honor  to  the  memory  of  its  founder. 
The  hospital  is  for  the  exclusive  use  of  the  native  sick 
poor  and  is  maintained  entirely  at  government  expense. 
The  liospital  is  an  immense  one-story  stone  building, 
with  accommodations  for  360  patients.  It  is  an  oldr 
fashioned  structure,  which  lacks  many  of  the  impor- 
tant features  of  a  modern  hospital,  and  it  is  about  time 
that  it  should  give  way  to  a  new  building  better  adapted 
for  present  requirements. 

Three  new  two-story  stone  pavilions  were  opened  in 
1892.  the  Sir  Dinshaw  Petit  Hospital  for  diseases  of 
women  and  children,  the  Bai  Motlaibai  Maternity  anql 
tlie  0))hthalmic  Hospital,  each  with  a  capacity  for  about 
forty  patients.  These  new  l)uildings  are  modern  in 
their  construction,  are  well  furnished  and  have  excel- 
lent little  operating  rooms.  The  nursing  is  also  better 
tlian  in  the  old  hospital.  About  800  women  are  deliv- 
ered annually  in  the  Maternity  'Hospital,  and  two  stu- 
dents attend  each  case;  this  gives  them  an  excellent 
opportunity  to  become  conversant  with  practical  obstet- 
rics. The  most  careful  aseptic  precautions  are  employed 
and  sepsis  in  in-patients  is  almost  unknown.  The  de- 
liverv  room   lias   ail  tlic  austere  appearances   and  sim- 


INDIA.  263 

l)licity  of  an  operating  room.  Two  womoii  were  in 
labor  when  1  visited  this  department  of  the  hospital. 

Professor  Dimmock  showed  me  a  number  of  interest- 
ing- oases  on  which  lie  had  recently  performed  major 
g\Tiecologic  operations.  In  the  old  building  a  small 
ward  has  been  converted  into  an  operating  room  sup- 
plied with  the  most  primitive  outfit  for  asepsis.  (See 
Fig.  o2.)  What  this  hospital  is  sadly  in  need  of  is  a 
new  and  separate  operating  theater  and  a  more  com- 
plete set  of  surgical  instrmnents.  It  is  a  great  injus- 
tice to  the  surgical  staff  to  be  obliged  to  perform  5,000 
operations  annually  under  such  trying  circumstances. 
All  hospital  surgeons  in  India  confess  that  it  is  ex- 
tremely difficult  to  prepare  a  native  for  operation.  A 
patient  recently  admitted  to  the  surgical  wards  of  Pro- 
fessor Quicke  for  the  purpose  of  undergoing  an  opera- 
tion for  the  radical  cure  of  an  inguinal  hernia,  brought 
with  him  the  following  sources  of  infection:  Scabies, 
ringworm,  diffuse  furunculosis  and  pyorrhea  alveolaris. 

The  nursing  of  this  institution  leaves  much  to  be 
desired.  The  trained  female  nurses  are  inadequate  in 
number,  and  it  is  only  recently  steps  have  been  taken 
to  organize  a  training  school.  Most  of  the  nursing  is 
done  under  their  supervision  by  male  and  female  w^ard 
attendants.  The  house  staff,  consisting  of  three  medical 
officers  of  the  Indian  Subordinate  Medical  Depart- 
ment, is  made  up  of  a  house  surgeon  and  two  assistant 
house  surgeons.  The  house  surgeon  has  charge  of  the 
property,  his  work  being  largely  that  of  an  executive 
officer,  but,  in  the  absence  of  the  regular  attending 
staff,  he  attends  to  the  emergency  cases,  medical  and 
surgical.  The  first  assistant  surgeon  has  charge  of 
tlie  drug  room  and  dispensary,  and  the  second  assistant 
attends  to  the  admission  of  patients  and  makes  the  pre- 
liminary examinations.  The  fourth  and  fifth  year  stu- 
dents do  much  of  the  dressing,  under  the  supervision 
of  the  house  surgeoii  and  attending  staff,  and  they  assist 
at  operations.     The  bedside  clinics  are   an   important 


264  AROUXD    THE    WORLD   VIA    INDIA. 

feature  of  the  clinical  teaching  in  this,  as  well  as  in 
all  other  medical  colleges  in  India.  The  attending  staff 
of  this  hospital  consists  exclusively  of  the  clinical  teach- 
ers of  Grant  Medical  College. 

PREVALENT   DISEASES. 

Tropical  abscesses  are  very  common  in  Bombay. 
They  affect  most  frequently  the  thighs  and  gluteal  re- 
gions. They  do  not  give  rise  to  serious  constitutional 
symptoms  and  the  local  symptoms  are  likewise  mild. 
Speedy  healing  after  incision  and  drainage  may  confi- 
dently be  expected.  Tetanus  is  most  frequently  met 
with  during  the  two  hottest  months  of  the  year,  April 
and  May.  The  serum  treatment  has  not  had  an  exten- 
sive trial,  and  the  mortality  is  large,  more  than  50  per 
cent.  In  one  case  an  intra-cerebral  injection  of  the 
antitetanic  serum  was  made.  The  patient  died.  On 
postmortem  the  serum  was  found  at  the  site  of  injection, 
no  absorption  having  taken  place.  In  the  treatment  of 
tetanus,  hydrate  of  chloral  and  potassic  bromid  in  very 
large  doses  are  relied  on.  Hydrophobia  is  quite  preva- 
lent in  India.  Bombay  sent  last  year  65  cases  of  sus- 
pected dog  bite  to  the  Pasteur  Institute  at  Simla.  Ele- 
phantiasis of  the  scrotum  is  much  more  common  among 
the  Parsees  than  among  the  Hindus.  Patients  thus 
affected  now  seek  surgical  relief  before  the  weight  of 
the  swelling  becomes  a  source  of  great  inconvenience, 
as  the  former  objections  to  the  operation  have  been 
overcome  by  the  better  operative  results.  Many  cases 
of  hydrocele  in  young  men  develop  during  the  hottest 
months  of  the  year.  About  from  fifty  to  sixty  patients 
with  stone  in  the  bladder  apply  for  relief  every  year. 

Hernia  in  women  is  very  rarely  met  with  in  India, 
and  the  surgeons  believe  that  this  is  due  to  their  spare 
bodies  and  tlie  vigorous  exercise  incident  to  the  hard 
work  the  common  women  are  required  to  undergo.  Sev- 
eral cases  of  Madura  foot  and  ainhqim  find  their  way 
int-o  the  hospital  every  year.     Actinomycosis  and  bias- 


INDIA.  3G5 

toinycosis  are  not  kno^\^a  here.  In  the  coolies  gonorrhea 
pursues  a  very  mild  course.  No  local  treatment  is  used. 
Under  internal  use  of  an  alkaline  mixture,  the  disease 
subsides  in  the  course  of  ten  days. 

HOMELESS  LEPER  ASYLUM,   MATUNGA,  BOMBAY. 

One  of  the  mo?t  creditable  and  beneficial  of  the  hun- 
dreds of  charity  institutions  of  Bombay  is  the  Home- 
less Leper  Asylum  in  the  suburb  Matunga.  It  is  the 
largest  leper  asylum  in  India,  and  at  present  it  is  the 
home  of  370  lepers.  The  inmates  are  well  cared  for. 
and  instead  of  living  the  lives  of  outcasts  in  misery, 
beggary  and  much  suffering,  are  well  housed,  kindly 
treated,  and  their  discomforts  and  pains  alleviated  to 
a  remarkable  degree.  Segregation  has  never  been  car- 
ried into  effect,  and  there  are  now  about  150  vagrant 
lepers  roaming  the  streets  of  Bombay.  Mr.  H.  A.  Ac- 
worth,  I.C.S.,  C.I.E.,  municipal  commissioner  for  the 
city  of  Bombay  from  1890  to  1895,  is  the  founder  of 
this  model  institution,  as  it  was  through  liis  influence 
that  the  necessary  funds  were  obtained.  Eich  mer- 
chants and  native  princes  responded  to  liis  appeal  and 
made  liberal  contributions.  The  many  tile-roofed,  one- 
story  brick  pavilions  are  situated  in  grounds  embrac- 
ing 111/)  acres  of  fertile  land,  advantageously  located, 
enclosed  and  unenclosed;  municipal  and  leased  from 
the  government  at  a  nominal  rent.  On  the  morning 
of  Nov.  7,  1890,  about  fifty  vagrant  lepers  were  col- 
lected by  the  health  department  and  the  police  at  various 
centers  and,  after  medical  examination,  were  sent  to 
the  asylum  under  police  escort  and,  after  thorough 
cleansing  and  change  of  clothes,  were  entered  as  the 
first  installment  of  patients  of  the  leper  home.  The- 
poor  lepers  have  since  learned  from  experience  and 
observation  the  full  extent  of  the  benign  and  hmnanC' 
intentions  of  the  asylum  and  now  enter  it  voluntarily 
in  increasing  numbers,  happy  in  the  -thought  that  by 
doing  so  their  short  lives  will  be  made  more  endurable 


2GG  AltOUND   THE    WORLD    VIA    IXDIA. 

by   the   care   and   kind   treatment  which   awaits   them 
there.     The  grounds  are  beautifully  laid  out  and  orna- 
mented with  trees  and  flowers.    The  garden  of  roses  is 
one  of  the  finest  in  Bombay.     In  the  grounds  there  is 
a  school   for  children,   a  Eoman   Catholic   Church,   a 
Hindu   temple   and    Mohammedan   mosque.      All    the 
Hindus  that  die  in  the  asylum  ai-e  cremated  by  the 
inmates,  according  to  the  Hindu  custom.     After  appro- 
priate ceremony,  in  a  place  set  apart  at  the  extreme 
east  comer  of  the  grounds,  the  rites  incidental  to  'cre- 
mation are  performed  by  the  patients  themselves,  and 
one  khandi    (28   maunds)    of  firewood  is  allowed   for 
each  corpse,  at  a  cost  of  8V2  rupees  ($2.72).     A  bier 
and  pall  are  provided  for  the  Mohammedans  and  the 
corpses  are  removed  to  the  cemetery  at  Marine  Lines 
by  bearers,  who  are  sent  from  tlie  city  and  are  paid  at 
the  rate  of  about  7  rupees  ($2.24)   per  corpse,  to  de- 
fray the  charges  of  conveyance  and  all  incidental  ex- 
penses.    A  Mohammedan  priest,  who  has  been  the  sub- 
ject of  the  anesthetic  form  of  leprosy  for  11  years  and 
an  inmate  of  the  asyhmi  for  5  years,  attends  to  the 
spiritual  needs  of  those  inmates  of  the  asylum  who  are 
of  the  same  religious  belief  and  receives  a  small  salary 
"for  his  services.     A  Eoman  Catholic  pri&st  from  Bom- 
bay visits  the  asylum  regularly  every  week.  The  Eoman 
Catliolic  dead  are  removed  from  the  asylum  for  burial 
at  the  expense  of  their  fund,  all  arrangements  being 
made  for  the  purpose  by  the  Eev.  Father  Peters,  S.J. 
The  Protestants  have  a  pauper  funeral  at  the  expense 
of  the  asylum  funds.     The  Protestant  missionaries  do 
not  seem  to  be  aware  of  the  existence  of  the  Homeless 
Leper  Asj^lum  or  it<  contingent  of  protestant  inmates. 
One  of  the  most  interesting  features  of  the  asylum  is 
the  small   sewage  farm  connected  with  it,   and  which 
is  fertilized  with  sterilized  sewage.     The  sterilization 
is  effected  by  collecting  all  the  sewage  and  passing  it 
through  a  series,  of  open  tanks.     This  method  of  ster- 
ilization  and   utilization   of   sewage  has    been    found 


INDIA.  267 

entirely  satisfactory  and  lias  been  a  source  of  no  incon- 
siderable income  to  the  asylum.  The  report  of  the 
asylum  shows  about  the  following  proportion  of  the 
various  religious  beliefs  of  the  inmates : 

Percentage. 

llindiis     (.Maliiattas)     6«.4:i 

Moliammedans     9.32 

Christians     10.61 

Hindus    (low    caste) 13.41 

Other   castes    23 

There  are  about  twice  as  many  men  as  women,  and 
the  children  constitute  about  2.51  per  cent,  of  all  the 
inmates.  One  of  the  touching  instances  among  the 
many  I  saw  in  visiting  this  great  institution  was  a 
group  of  children,  numbering  about  15,  who  had  just 
left  the  schoolroom  and  had  congregated  near  the  gate 
of  entrance  to  the  grounds  to  bid  the  visitors  good-bye. 
They  ranged  in  their  ages  from  6  to  12  years'  and  were 
all  lepers. 

The  anesthetic  and  tubercular  forms  of  the  disease 
are  about  equally  represented,  and  the  mixed  form 
affects  about  12.63  per  cent,  of  all  cases.  The  dispen- 
sary is  well  supplied  with  medicines,  the  hospital  is 
scrupulously  clean  and  supplied  with  comfortable  cots. 
A  physician  visits  the  asylum  every  day,  and  his  assis- 
tant resides  in  the  institution,  always  ready  to  render 
necessary  medical  and  surgical  aid. 

THE    PLAGUE    RESEARCH    LABORATORY    OF    THE    GOVERN- 
MENT  OF  INDIA,   PAREL^  BOMBAY. 

This  institution  owes  its  origin  to  Mr.  W.  M.  Haff- 
kine,  CLE.,  a  Eussian  scientist,  who  has  rendered  India 
such  signal  service  since  1893.  first  by  his  prophylactic 
treatment  of  cholera  by  serum  inoculations  and  later 
by  his  discovery  of  a  serum  against  the  plague.  I  was 
very  anxious  to  meet  Mr.  Haffkine,  but  imfortunately 
he  was  absent  on  a  visit  to'  Europe,  but  I  met  in  his 
place  Lieut.  Col.  W.  B.  Bannerman,  M.D.,  B.S.C., 
I.M.S.,  who  temporarily  filled  his  place  as  director-in- 
chief  oif  the  laboratory  and  who  holds  the  permanent 


208  AROUND    THE   WORLD    VIA    INDIA. 

position  as  superintendent.  The  former  residence  of 
tlie  governor  of  Bombay,  at  Parel,  a  beautiful  suburb, 
has  been  converted  into  a  laboratory  and  the  former 
ballroom  is  now  the  place  where  the  anti-plague  sermn 
is  brewed,  and  halls  and  bedrooms  where  fashion  reigned 
are  now  occupied  by  dozens  of  cages  containing  ani- 
mals for  experimental  use. 

According  to  a  paper  presented  by  Lieut.  Col.  Ban- 
nerman  to  the  Eoyal  Society  of  Edinburgh  in  1902, 
the  serum  treatment,  in  the  prevention  of  the  bubonic 
plague,  devised  by  Haffkine,  is  reliable  and  specific  in 
its  results.  The  immunity  thus  obtained  remains 
throughout  an  epidemic  and  has  been  known  to  last 
two  years;  its  exact  maximum  limits,  however,  remain 
imdetermined.  The  serum  is  prepared  on  a  very  large 
scale  and  is  sent  wherever  needed  free  of  expense 
through  government  channels.  Wide  bottles  with  long, 
narrow  necks,  holding  about  a  liter,  are  filled  with 
bouillon  and  the  culture  medium  is  inoculated  with  the 
plague  bacillus.  A  characteristic  growth  in  the  form 
of  innumerable  hanging  stalactite-like  threads  forms. 
At  the  end  of  two  months  the  culture  is  sterilized  by 
boiling  and  is  kept  ready  for  use  in  another  room.  The 
culture  and  serum  rooms  contain  hundreds  of  these 
bottles,  protected  against  contamination  by  a  cotton 
plug  with  ends  burnt  off.  The  prophylactic  treatment 
consists  in  making  a  single  hypodermatic  injection  of 
from  4  to  5  c.c.  of  Ihe  sterilized  culture  under  strictest 
aseptic  precautions.  All  subjects  thus  treated  have 
escaped  the  disease,  even  in  badly  infected  districts.  The 
experience  with  this  serum  has  reached  enormous  di- 
mensions and  its  absolute  reliability  can  no  longer  be 
questioned.  Accidents  have  happened,  but  they  could 
always  be  traced  not  to  the  serum  per  se,  but  to  its  im- 
proper administration.  Bannerman  concludes  his  paper 
as  follows :  "The  final  conclusion,  then,  appears  to  be 
that  in  this  discovery  of  Haffkine's  we  have  within  our 
reach  a  means  of  controlling  an  epidemic  of  plague  and 


INDIA.  2G9 

converting   it   into    a   manifestation    of   sporadic    cases 
only,  easily  controlled  and  exciting  little  alarm." 

Haffkine  receives  a  salary  of  3,000  rupees  ($640)  a 
month,  an  amount  not  any  too  large  for  the  man 
through  whose  scientific  researches  two  of  the  most 
dreadful  epidemic  diseases  of  India  are  on  the  way  to 
extinction. 

BOMBAY  BUBONIC  PLAGUE  HOSPITAL. 

During  my  tour  through  the  tropics  I  made  frequent 
inquiries  at  the  different  ports  for  the  purpose  of  find- 
ing an  opportunity  to  see  cases  of  bubonic  plague.  All 
the  i^orts  were  free  from  this  disease  until  I  came  to 
Bombay.  For  four  years  Bombay  has  been  the  center 
of  an  epidemic  of  this  disease  and  in  consequence  a 
dreaded  port  for  navigators  and  ship  owners.  The 
disease  has  passed  its  climax  and  is  gradually  being 
gotten  under  control.  The  plague  hospital  is  located 
outside  of  the  city  limits  and  consists  of  a  row  of  one- 
story  brick  buildings  which  serve  as  wards. 

During  the  height  of  the  epidemic  as  many  as  30 
patients  a  day  were  admitted  from  the  city  and  nearby 
villages.  The  mortality  has  been  very  great.  Many 
die  from  the  general  sepsis,  others  from  pulmonary  and 
other  complications.  After  a  period  of  incubation  of 
from  five  to  seven  days,  the  disease  is  ushered  in  abrupt- 
ly with  very  high  temperature  and  other  symptoms 
indicative  of  a  profound  constitutional  disturbance. 
The  inguinal  glands  are  most  frequently  involved,  next 
the  glands  of  the  axillary  spaces.  The  cervical  glands 
are  very  seldom  affected.  Enucleation  of  the  suppurat- 
ing glands  has  been  tried,  but  was  abandoned,  as  it  was 
foimd  that  after  such  attempts  to  cut  short  the  local 
infection,  the  general  infection  usually  became  aggra- 
vated. 

The  local  treatment  resorted  to  now  consists  in  the 
use  of  poultices  until  fluctuation  is  distinct  when  the 
abscesses    are   incised    and   antiseptic    gauze    dressings 


270  AROUND  THE  WORLD  VIA  INDIA. 

take  the  place  of  the  poultices.  The  general  treatment 
is  supporting  and  stimulating.  Large  abscesses  fre- 
quently develop  remotely  from  the  infected  glandular 
regions.  At  the  time  of  my  visit  about  25  patients 
remained  in  all  stages  of  the  disease.  Some  of  them 
were  in  the  height  of  the  primary  fever,  more  of  them 
were  slowly  recovering  from  extensive  glandular  ab- 
scesses in  the  inguinal  regions.  I  saw  only  two  patients 
in  whom  the  axillary  glands  were  also  involved.  In 
all  the  inguinal  abscesses  that  had  been  incised  the  en- 
larged glands  partially  isolated  from  the  surrounding 
tissues  presented  a  grayish  appearance  with  no  indica- 
tions of  any  attempt  at  repair. 

Some  of  these  survivors  had  been  in  the  hospital  for 
t^v^o  or  more  months.  One  of  the  convalescents,  who 
had  recovered  sufficient  strength  to  walk  about,  had  lost 
his  speech,  the  result  of  cerebral  complications  which 
set  in  during  the  acute  stage  of  the  disease.  All  con- 
valescents were  emaciated  to  an  extreme  degree.  Three 
heroic  trained  female  nurses  take  care  of  the  sick,  aided 
by  male  and  female  helpers.  One  of  tliese  nurses  has 
been  on  constant  duty  since  the  epidemic  commenced, 
more  than  four  years  ago,  and  notwithstanding  the 
arduous  and  trying  duties  that  she  has  so  faithfully 
performed  her  general  health  has  not  suffered;  an  in- 
teresting proof  of  woman's  endurance  under  circum- 
stances that  would  be  a  severe  test  on  the  strength  of 
tlie  strongest  man. 

A  COBRA  DEN". 

My  visit  to  tlie  research  laboratory  was  made  late 
in  the  day.  It  was  during  the  short  twilight  and  in 
the  absence  of  electric  or  gas  lighting  we  had  to  find 
our  way  through  the  dark  halls  and  rooms  of  the  for- 
mer palace  of  the  governoi-s  of  Bombay  with  the  aid  of 
the  light  of  a  lantern.  Lieut.-Col.  Bannerman  led  the 
way.  We  passed  through  halls  and  rooms  on  the  first 
floor  between  rows  of  cages  containing  rabbits,  guinea 
pigs,  rats  and  mice,  and  the  little  creatures,  scared  by 


INDIA,  371 

the  appearance  of  tlie  late  visitors,  were  roused  from 
their  dormant  condition  and  displayed  an  activity  be- 
gotten by  fear.  We  finally  came  to  the  door  of  a  large 
room  in  whicli  darkness  was  complete.  The  moment 
we  entered  a  fearful  hissing  from  every  part  of  the  room 
greeted  us,  mingled  with  short  raps  resembling  the  tap- 
ping sound  made  by  striking  a  wire  screen  with  a  small 
hammer.  I  was  in  a  cobra  den,  in  the  midst  of  150 
of  these  terrible  reptiles,  imprisoned  in  cages,  it  is 
true,  but  wide  awake  and  roused  to  anger  by  our  un- 
timely intrusion.  They  were  assisted  in  their  hissing 
and  striking  against  the  wire  screen  which  guarded  the 
open  end  of  their  cages  by  50  otlier  snakes  still  more 
venomous,  Russel's  viper.  (Dahoia  BusselU.)  Through 
the  meshes  of  the  wire  screen  shot  the  red  forked  tongues 
of  200  of  the  most  venomous  reptiles  known.  Add  to 
the  hissing  and  striking  noises  the  200  forked  red 
tongues,  400  staring,  deceptive  and  treacherous  eyes, 
the  snaky  odor  that  pervaded  the  atmosphere  of  their 
dungeon  and  you  will  have  a  good  idea  of  what  is  meant 
by  a  cobra  den.  The  cobra  (Naia  tripudians)  is  about 
four  feet  in  length,  and  when  angered  the  flat  head 
and  neck  expand  into  wing-like  projections  on  each 
side,  increasing  their  width  to  the  size  of  the  palm  of 
the  hand.  The  color  is  almost  black,  the  tail  taper- 
ing into  a  sharp  point.  The  viper  is  of  about  the  same 
size,  but  has  circular  stripes.  I  know  of  no  more  ugly 
sight  than  a  cobra  in  striking  attitude.  Every  snake 
in  the  room  was  in  a  fighting  mood,  hissing  and  strik- 
ing the  wire  screen  with  a  thud-like  noise;  at  short 
intervals  red  forked  tongues  shot  out  through  the 
meshes  of  the  wire  screen  on  all  sides,  and  the  situa- 
tion was  made  more  horrible  by  the  revolting  snake 
smell  issuing  from  so  many  cages. 

The  snake,  the  most  despised  animal  in  creation,  is 
an  object  of  fear  and  horror  to  all  who  are  familiar 
with  his  damnable  record  in  the  Garden  of  Eden,  and 
with  the  curses  imposed  on  him  by  the  Almighty.     I 


273  AROUND   THE    WORLD    VIA    INDIA. 

did  not  know  but  some  of  these  terrible  beasts  mighi 
be  at  liberty  in  that  large  imperfectly  lighted  room, 
and  breathed  easy  again  only  after  we  had  left  the  room 
and  the  door  was  shut  and  securely  locked. 

It  was  prearranged  that  I  should  become  more  fa- 
miliar with  the  dangerous  part  of  the  anatomy  of  cobra 
and  viper.  We  ascended  the  broad  staircase  leading 
to  the  second  floor  and  entered  the  office  of  the  superin- 
tendent of  the  laboratory,  Lieut-Col.  Bannerman,  who  on 
this  occasion  extended  so  many  courtesies  to  me.  He 
sent  for  the  "snakeman."  and  in  a  very  short  time 
three  coolies  made  their  appearance  with  as  many  snakes 
in  their  cages,  one  cobra  and  two  vipers.  I  was  to 
witness  the  "milking-^^  of  their  poison  sacs.  I  begged  to 
he  informed  beforehand  how  this  was  to  be  done  in 
order  that  I  might  make  my  own  plans  of  conduct  for 
safet}'  during  the  ordeal.  The  superintendent  smiled 
and  said :  "You  must  see  for  yourself."  The  snakes 
were  in  an  ofEensive  attitude,  as  they  had  undergone 
this  procedure  repeatedly  and  had  learned  by  experience 
to  dread  it.  I  could  see  no  opening  in  the  boxes  through 
which  the  snakes  could  be  made  hors  de  combat. 

The  "snakeman"  was  a  very  slender  coolie,  with  very 
long,  thin  arms  and  legs,  and  fingers  like  tlie  claws  of 
a  monkey.     (Fig.  53.) 

The  cobra,  with  its  raised,  expanded  head  in  striking 
position  came  first.  The  man  held  a  smooth  stick  the 
size  of  an  ordinary  cane  and  about  two  feet  in  length 
in  his  left  hand.  Suddenly,  standing  behind  the  box 
with  the  wire  screen  directed  toward  him,  he  threw 
open  the  opposite  side  with  a  lightning  jerk  and  out 
shot  the  angry  monster,  and  in  undulating  rapid  move- 
ments advanced  toward  me.  A  quick  retreat  on  my 
part  beliind  the  table  increased  tlie  distance  between 
us.  Before  the  snalce  had  advanced  three  feet  the 
"snakeman"  grasped  the  end  of  his  tail  with  a  light- 
ning movement  of  the  right  hand,  lifted  it  high  in  the 
air.  and  with  the  stick  passed  from  tail  to  neck  pre- 


Fig.    53. — Hindu    snake    charmer. 


INDIA.  275 

vented  a  recoil,  lowered  it  to  the  floor.  With  the  stick, 
the  neck  was  pressed  against  the  floor,  the  right 
hand,  quickly  substituted  for  the  stick,  grasped  the 
neck  firmly  and  with  the  left  hand  made  traction  on 
the  tail,  thus  straightening  out  the  squirming  body.  A 
small  goblet,  covered  drum-like  with  American  adhesive 
plaster  with  adhesive  side  directed  outward,  was  placed 
near  enough  for  the  snake  to  strike  it.  The  fangs 
penetrated  the  plaster  and  by  pressure  against  the  poison 
sacs  about  half  a  dram  of  viscid  opaque  fluid  escaped 
into  the  sterilized  goblet.  The  cobra  was  returned  into 
the  cage  with  the  same  expertness  as  characterized  its 
liberation.  The  whole  procedure  did  not  occujjy  more, 
than  ten  minutes.  Snakes  refuse  all  food  during  con- 
finement, hence  they  are  fed  each  time  the  poison  is 
removed,  which  is  done  every  10  days.  The  long  tip 
of  a  small  funnel  is  inserted  into  the  throat  and  about 
two  ounces  of  a  mixture  of  egg  and  milk  is  poured  into 
the  funnel,  which  enters  the  alimentary  canal  witliout 
meeting  any  obstruction.  The  vipers  were  then  handled 
in  a  similar  manner,  only  that  in  their  case  the  poison 
was  received  direct  from  the  fangs  into  an  open  goblet 
by  opening  the  moutli  widely  with  a  pair  of  forceps 
and  steadying  the  fangs  with  a  thread  passed  around 
them  and  on  which  traction  was  made  by  an  assistant, 
who  at  the  same  time  held  the  goblet.  I  could  see  dis- 
tinctly the  drops  of  poison  escape  through  the  tiny  open- 
ing at  the  very  tip  of  the  enormous  fangs,  which  looked 
like  fish  hooks  without  a  barb. 

The  poison  is  desiccated  in  the  laboratory  under 
aseptic  precautions,  and  is  later  sent  to  another  labora- 
tory, where  it  is  used  in  the  preparation  of  Calmette's 
antivenen.  There  is  no  lack  of  an  adequate  supply 
of  cobras  and  vipers  for  this  laboratory  as  tliey  are 
bought  from  the  natives  at  from  a  few  annas  to  one 
rupee  each. 


276  AROUND    THE    WORLD    VIA    INDIA. 

calmettf/s  ANTIVENENE. 

Calmette  of  Lille  is  the  discoverer  of  antivenene. 
Captain  Lamb,  I.M.S./  who  has  made  a  very  careful 
study  of  the  tlierapeutic  value  of  this  agent  in  the  treat- 
ment of  bites  of  poisonous  snakes  has  come  to  the  con- 
clusion that  antivenene  prepared  from  the  venom  of 
one  genus  of  snake  is  curative  only  in  the  treatment  of 
bites  inflicted  by  that  genus  and  no  other,  a  position 
fully  endorsed  by  Lieut.-Col.  Bannerman.^^  Convincing 
experimental  research  and  a  large  clinical  experience 
combine  to  prove  that  the  antivenene  prepared  from 
the  cobra  venom  is,  if  used  in  time,  a  specific  for  cobra 
bites,  but  useless  in  the  treatment  of  bites  of  the  viper. 
Reasoning  from  this  standpoint,  it  seems  to  me  that 
in  antivenene  prepared  from  the  venom  of  our  rattle- 
snake ought  to  prove  successful  in  the  treatment  of 
bites  inflicted  by  this  genus  of  snakes. 

Only  one  accident  has  so  far  occurred  in  the  Parel 
I>aboratory.  A  coolie  in  handling  a  cobra  struck  one 
of  his  thmubs  against  one  of  the  fangs.  Antivenene 
of  doubtful  age  was  used  at  once,  but  proved  useless 
in  warding  off  the  immediate  symptoms  provoked  by 
the  poison.  Great  prostration  set  in,  he  became 
paralyzed  in  the  lower  limbs  and  unconscious.  The 
tlireatening  symptoms  disappeared  promptly  and  in 
three  hours  the  patient  was  able  to  walk  to  his  house. 
Gangrene  of  the  end  of  the  thuiul).  however,  occurred, 
wliicli  proved  the  intensity  of  the  local  toxic  action 
of  the  cobra  venom. 
Marseilles,  France,  Oct.  3,  1904. 


1.  Snake    Venooms :    Thfir    Physiological    Action    and    Antidote, 
.Tdurnal   Bombay   Natural   Histoi-y   Society,    r>.   220,   vol.   xiv. 

2.  The  Use   of  Calmette's   Antivenene   in    Snakebites   in    Indiaa, 
Journal    Kombay    Natural    Histdry    Society,    vol.    xv. 


FOUK    THOUSAND    MILES    THROUGH    INDIA 
BY  EAIL  IN  MIDSUMMER. 

When  1  (Urided  lo  make  a  tour  around  the  world  by 
Avay  of  India,  (hii'inii'  inidsuiuuier,  I  knew  beforehand 
that  I  would  have  no  ust'  in  that  part  of  the  world  for 
an  overcoat  or  blankets.  1  was  very  well  aware  of  the 
fact  that  that  part  of  India  which  I  expected  to  see  had 
an  unenviable  reputation  as  a  summer  resort.  Informa- 
tion from  diiferent  sources  concerning  the  climate  of 
certain  countries  is  aboul:  as  reliable  as  hunting  and 
■fishing  stories.  In  order  to  ascertain  about  what  I 
had  to  expect  in  the  way  of  heat  at  that  time  of  the 
year,  I  interviewed  sea  captains  and  people  who  had 
lived  in  India.  The  opinions  expressed  were  so  widely 
at  variance  that  I  remained  in  doubt  concerning  the 
real  climatic  conditions  that  I  would  have  to  encounter 
in  that  part  of  my  itinerary  around  tjie  world.  A  trav- 
eling companion  from  San  Francisco  to  Auckland,  a 
missionary,  who  had  lived  several  years  in  the  northern 
part  of  India,  gave  me  the  most  discouraging  account. 
He  said  that  where  he  formerly  resided  the  burning 
sun  during  summer  heated  the  stones  to  such  a  degree 
that  a  simple  touch  with  the  hand  would  result  in 
a  burn  sufficient  to  blister  the  skin.  An  officer 
of  the  Indian  Medical  Service  gave  me  the  consoling 
information  that  when  he  was  on  duty  at  Calcutta  he 
had  to  spend  several  hours  each  day  in  a  cool  bath  dur- 
ing the  summer  months  to  counteract  the  intensity  of 
the  heat.  Sea  captains  were  only  familiar  with  the 
climate  on  the  coasts  of  India;  they  knew  nothing 
about  the  summer  climate  of  the  great  plains  which 
I  expected  to  cross.  Their  opinions  on  the  coast  cli- 
mate were  not  unanimous.  They  could  be  formulated 
about  as  follows:     A^ery  hot,  hot,  quite  hot,  not  so  bad 


278  AROUND    THE    WORLD   VIA    INDIA. 

as  1ms  been  represented.  In  view  of  these  testimonies, 
I  approached  the  climate  of  India  with  a  mixed  feeling 
of  hope  and  fear.  After  having  crossed  the  equator 
twice  on  the  way  from  San  Francisco  to  Ceylon,  I  spent 
five  days  in  the  hot,  humid  climate  of  Ceylon,  and  for 
the  first  time  fixed  my  eyes  on  "India's  Coral  Strand" 
early  Tuesday  morning,  August  30.  From  subsequent 
experience,  I  would  suggest  the  following  change  in 
the  second  line  of  the  famous  and  well-known  mis- 
sionary hymn : 

From    Greenland's    icy    mountains 
From   India's  "burning"  strand, 

as  this  change  would  more  forcibly  indicate  the  dif- 
ference in  the  climatic  conditions  of  these  two  places 
which  these  lines  are  intended  to  convey.  The  first  im- 
pression of  India  in  landing  at  Tuticurin  is  very  dis- 
appointing. Unlike  the  South  Sea  Islands  and  Cey- 
lon, the  coast  is  not  fringed  with  palm  trees;  it  is  bare 
and  barren.  The  country  is  level  and  vegetation  very 
scanty.  The  part  of  India  which  I  traversed,  and  the 
tour  extended  from  Tuticurin  to  Bombay,  via  Madras, 
Calcutta,  Benares,  Allahabad,  Agra,  Delhi,  Jaipur  and 
Ahmedabad,  is  entirely  devoid  of  interesting  scenery. 
There  are  no  forest-clad  mountains,  waterfalls,  moun- 
tain lakes,  babbling  springs  nor  clear  rivers.  Most  of  the 
river  beds  are  dry  or  are  a  succession  of  dirty  pools,  the 
favorite  bathing  and  drinking  places  for  man  and  beast. 
The  sacred  Ganges  at  Benares  is  about  the  size  of 
the  Mississippi  at  St.  Louis.  It  is  the  great  sewer  for 
millions  of  people ;  its  dirty  Avater  is  credited  with  great 
healing  power  by  the  superstitious  population  and  is 
carried  in  earthern  or  brass  vessels,  or  pigskins,  great 
distances  for  drinking  purposes,  as  it  is  supposed  to 
possess  virtues  which  will  prevent  and  cure  all  kinds 
of  diseases.  When  we  realize  that  the  river  is  used  as 
a  receptacle  for  corpses,  dead  animals  and  everything 
that  is  filthy,  it  is  difficult  to  comprehend  how  Mark 
Twain  could  come  to  the  conclusion  that  its  water  is 


INDIA. 


379 


the  purest  in  the  workl  uiid  sing  its  praises.  This 
great  traveler  has  iininortalized  himseli'  with  the  na- 
tives of  India  by  lauding  the  purity  of  the  (lauges  water. 
He  may  be  right  from  a  bacteriologic  standpoint,  and 
his  position  would  be  upheld  by  the  Chicago  Depart- 
ment of  Healtli,  but  would  meet  with  violent  opposi- 
tion by  the  guardians  of  health  of  the  city  of  St.  Louis. 
When  I  saw  this  sacred  stream,  its  water  was  about 
the  color  of  pea  soup,  and  during  a  boat  ride  along  its 
shores  I  saw  a  number  of  decomposed,  bloated  dead  dogs 
floating  on  the  surface  of  the  sluggish  stream,  and  at 
the  place  where  the  corpses  of  himian  beings  are  cre- 
mated, baskets  of  ashes  were  consigned  to  its  sacred 
water.  The  soul  of  the  Hindu  finds  no  rest  until  at 
least  a  part  of  the  incinerated  remains  is  deposited  in 
this  river.  From  the  ashes  of  the  cremated  bodies  a 
few  fragments  of  bones  are  taken,  tied  up  in  a  cloth 
and  sooner  or  later  this  ghastly  bundle  must  be  thrown 
into  the  Ganges,  even  if  this  part  of  the  funeraJ  rites 
require  days  and  weeks  and  no  inconsiderable  expense 
incidental  to  the  travel.  It  is  fortunate  that  this  river 
is  inhabited  by  crocodiles,  which  can  dispose,  at  least, 
of  some  of  the  bodies  and  carcasses  which  are  thrown 
into  it  by  the  hundreds  and  thousands  every  day.  In 
the  inhabited  parts  of  the  country  through  which  the 
Ganges  passes,  its  shores  are  lined  witli  washerwomen 
and  washermen  and  human  and  animal  bathers.  The 
amount  of  human  excreta  which  find  their  way  into 
this  stream  is  simply  enormous,  and  other  sources  of 
pollution  are  innumeral)le ;  hence,  if  nature's  laboratory 
can  cope  successfully  with  so  many  sources  of  contam- 
ination and  render  the  water,  if  not  clean,  yet  potable 
and  bacteriologically  pure,  she  has  done  what  sanitarians 
so  far  have  failed  to  accomplish. 

I  have  said  that  the  part  of  India  included  in  my 
tour  lacks  scenic  l^eauty.  It  is  monotonous,  a  great, 
level,  limitless  plain,  covered  by  rich  marshes  on  the 
west  coast;  deserts,  pastures,  grain  and  cornfields  in 


280  AROUND    THE    WORLD    VIA    IXDIA. 

the   interior  and   along  the   Indian   Ocean   coast;   very' 

little    fruit    culture    anywhere.      Between  Madras    and 

Calcutta,  and  in  the  vicinity  of  Jaipur,  the  monotony 

of    the    landscape    is    somewhat    relieved    by    mountain. 

ranges,   which   are,   however,   almost   bare,   dotted   only 

here  and  there  with  clumps  of  shrubs    and    dwarfed, 

hardy,  much-branched  trees. 

Water  is  India's  greatest  concern.     On  the  amount 

of  rainfall  depends  the  success  or  failure  of  the  crops. 

All  the  results  of  agriculture  are  dependent  not 
so  much  on  reason  and  diligence,  as  on  those 
most  uncertain  things,  Avinds  and  weather." — 
Cicero. 

Deforestation  has  impoverished  India,  as  it  has  the 
Holy  Land,  Greece,  Turkey,  Spain,  southern  Austria, 
and  parts  of  the  United  States.  The  building  of  reser- 
voirs and  dams  to  hold  heaven's  gift  have  sncceeded 
only  in  part  in  preventing  drouths  when  the  rainfall  is 
scanty.  The  government  has  at  last  recognized  the  true 
cause  of  the  frequent  drouths,  and  in  1880  passed  laws 
prohiljiting  further  forest  destruction,  and  took  active 
steps  to  restore  what  had  l^een  lost  by  the  reckless, 
thoughtless,  destructive  work  of  man.  The  results  of 
the  efforts  of  reforestation  are  apparent  in  many  parts 
of  the  country,  and  if  this  good  work  is  carried  on  with 
the  deserved  energy,  India  will  get  its  good  share  of 
rain  in  less  than  a  hundred  years;  the  farmer  will  reap, 
from  year  to  year,  the  rewards  of  labor,  famine  will 
disappear  and  the  general  prosperity  of  the  country 
will  reach  a  degree  never  known  before.  Nature  ha.^ 
made  provision  for  reforestation  of  arid  regions.  In 
the  desert  of  Sahara,  along  the  banks  of  the  Suez  Canal, 
[  noticed  a  shrub  from  4  to  8  feet  high,  with  a  dark 
green  foliage — the  Tamarix  tetragyna — in  pla<!es  where 
nothing  else  would  grow.  This  shrub  is  pre-eminently 
fit  for  dry  saline  soil.  The  leaves  are  eaten  by  cattle. 
This  shrub  would  flourish  in  the  deserts  of  our  western 
states. 

At  present  the  laboring  classcrs  spend  much  of  their 


INDIA.  281 

time  and  labor  in  liolding  and  distxibuting  the  limited 
water  supply.  In  some  districts  the  government  has 
established  well-planned  systems  oi'  irrigation,  wldch 
have  brought  millions  of  acres  of  arid  land  under  suc- 
ce^^sful  cultivation.  Beyond  the--e  areas,  the  farmer, 
during  thie  dry  season,  spends  most  of  his  energies  in 
supplying  tlie  arid  soil  with  moisture  by  the  most  primi- 
tive methods.  From  pools,  tanks  and  wells,  water  is 
drawn  in  pails,  by  hand,  foot  or  bullock  power,  in  the 
same  way  as  was  done  a  thousand  years  and  more  ago. 
I  never  saw  a  windmill  in  India.  The  water  is  poured 
into  little  gutters,  which  intersect  the  fields  in  different 
directions.  Men,  women  and  children  are  engaged  i)i 
this  kind  of  work.  The  women  supply  the  houseliiold 
with  water  and,  as  the  wells  are  frequently  far  apart, 
this  task  is  often  not  an  easy  one.  Hard  as  this  work 
may  be,  it  has  its  fascination  for  the  women.  They 
congregate  at  the  well,  chatter  and  laugh  while  the 
earthen  or  brass  vessels  are  being  filled,  and,  when 
perched  on  their  well-balanced  heads,  return  in  files  to 
their  village,  keeping  up  their  lively  conversation  until 
the  one  from  the  greatest  distance  finds  herself  alone. 
The  erect,  graceful  stature  of  the  laboring  native  women 
is  largely  due  to  this  enforced  useful  g^^mnastic  exercise. 
A  common  way  of  dipping  water  from  a  tank  or  pool 
into  an  irrigating  ditch  is  by  means  of  a  large  water- 
proof basket  made  of  palm  leaves,  to  which  is  attached 
a  piece  of  rope  on  opposite  sides.  Two  persons  swing 
this  basket  so  regularly  and  skillfully  that  it  catches 
the  water  on  one  side  and  discharges  it  on  the  other. 
To  maintain  the  proper  tempo  of  these  swinging  move- 
ments between  the  two  persons  so  employed,  a  monot- 
onous chant  regulates  the  muscular  movements.  Pumps 
appear  to  be  unknown.  When  bullocks  take  tJie  place 
of  man  power,  the  water  is  drawn  from  the  well  in  an 
irmnersed  bucket,  the  traction  rope  running  in  the 
groove  of  a  wheel  about  two  feet  in  diameter.  The  bucket 
is  swung  in  the  desired  direction  by  a  man  and  emptied. 


283  AROUND    THE   WORLD   VIA   INDIA. 

The  bullock's  work  is  not  so  easy  as  it  might  seem.  The 
run  is  a  short  one  and  the  animal  is  not  a  very  lithe  one, 
and  the  constant  turning  movements  must  be  much 
more  fatiguing  than  the  traction  in  a  straight  direc- 
tion over  such  a  short  distance. 

The  elevation  of  water  from  a  well  by  a  beam,  kept  in 
motion  by  up-and-down  movements  by  the  to-and-fro 
walking  on  it  of  one  or  more  boys,  can  not  be  regarded 
in  the  light  of  a  childish  play.  The  actors  must  be 
sure-footed  in  walking  back  and  forth  on  the  polished 
beam,  and  when  the  exercise  is  kept  up  for  hours  the 
muscles  of  the  legs  and  back  have  certainly  undergone 
a  great  strain,  and  when  this  work  is  done  under  the 
burning  rays  of  the  sun,  it  means  a  bodily  exertion 
which  would  exhaust  the  strength  of  our  best  athletes 
in  a  surprisingly  short  time, 

ATTRACTIONS    OF    INDIA. 

I  did  not  go  to  India  with  the  expectation  of  seeing 
enchanting  scenes,  hence  I  was  not  disappointed  at  their 
absence.  I  had  seen  most  of  the  finest  scenery  in  the 
world,  including  Alaska,  Yellowstone  Park,  Yosemite 
Valley,  Switzeiiand,  Norway,  Tyrol,  Siberia,  West  In- 
dies, Central  America,  Taliiti,  etc.,  and  I  came  to  India 
to  see  what  is  generally  recognized  as  the  most  interest- 
ing country  in  the  world.  I  came  to  India  to  see  her 
people,  temples,  palaces,  tombs,  her  works  of  ancient 
art,  her  trees,  flowers  and  animals.  Having  seen  as 
much  as  possible  of  tliese  things  during  the  short  space 
of  eighteen  days,  traveling  at  the  same  time  more  than 
4,000  miles  by  rail  and  during  the  worst  season  of  the 
year,  I  feel  fully  compensated  for  tlie  risks  incurred 
and  the  sufferings  endured,  and  can  only  repeat  what 
has  so  often  been  said,  that  the  real  traveler,  not  the 
sightseer,  will  find  here  more  that  will  interest  him  than 
in  any  other  country  in  the  world. 

Take  away  from  the  Holy  Land  sacred  history  and 
its  remaining  landmarks,  and  it  could  furnish  no  such 


INDIA.  383 

attractions  as  can  India,  the  land  of  ancient  history, 
civilization,  art  and  science.  Tlie  tombs  and  pyramids 
of  Egypt  are  modern  when  compared  witli  the  ancient 
temple  ruins  in  India.  The  history  of  Eome  is  as  o£ 
to-day  when  contrasted  with  the  records  of  India,  punc- 
tured indelibly  in  characters  on  palm  leaves  used  as  writ- 
ing nuiterial  for  thousands  of  years,  and  carefully  pre- 
served in  the  temples,  which  axe  practically  fireproof, 
and  many  of  them  never  touched  by  the  rude  hand  of 
war  and  plunder.  The  ancient  history  of  Egypt  must 
be  studied,  not  in  Egypt  but  in  the  British  Museum, 
while  to  become  familiar  with  tlie  earliest  history  of 
India,  it  must  be  studied  in  India  itself.  India  has 
landmarks  in  history  that  can  not  be  transported  like 
Cleopatra's  needle,  landmarks  that  would  be  ruined  and 
made  valueless  if  tiiey  were  taken  from  tlie  places  where 
they  were  built  thousands  of  years  ago.  People  from 
all  parts  of  the  world  may  be  seen  at  a  world's  fair  ex- 
hibition, but  it  is  impossible  to  know  them  or  to  learn 
tlieir  habits  and  customs,  their  vices  and  virtues  until 
they  are  seen  at  their  houses,  at  their  places  of  busi- 
ness, on  their  farms,  at  their  public  amusements,  in 
their  own  envi:  onments.  A  native  in  a  distant  strange 
lajid  on  exhibition  is  no  more  of  a  native  than  is  a  lion 
in  a  cage  to  be  compared  with  a  lion  in  the  deserts  of 
Nubia. 

And,  after  all 

"The    proper    study    of    mankind    is    man." — 
Pope. 

The  average  tourist  wants  to  see  beautiful  scenery, 
to  walk  picture  galleries,  to  attend  operas  and  concerts, 
to  get  a  glimpse  of  and,  if  it  is  at  all  possible,  to  come 
in  touch  with  royalty  or  with  persons  of  high  position 
and  social  influence.  The  true  traveler,  on  the  otlier 
hand,  spends  much  of  his  time  among  the  masses  of  the 
common  people,  the  backbone  of  every  nation.  He  is 
anxious  to  learn  from  his  own  observations  what  they  do 
and  how  they  live.     He  sees  them  work  iii  the  fields  and 


284  AROUND    THE    WORLD    VIA    INDIA. 

he  visits  them  in  their  huts.     He  visits  the  markets  to 
learn  what  the  country  produces,  and  he  ascertains  the 
prices  of  foodstuffs.   He  studies  the  habits  and  customs 
of  the  people,  their  clothing,  their  implements  of  agri- 
culture and  war  and  the  tools  of  the  artisans.     He  looks 
into  the  little  shops  and  finds  out  what  the  people  buy 
a;jid  sell.     He  makes  a  study  of  the  trees,  flowers  and 
animals,  domestic  and  Avild.     He  frequents  the  botanic 
and  zoologic  gardens  and  museums.     He  takes  special 
interest  in  the  landmarks  of  history,  ancient  and  mod- 
ern, and  the  educational  advantages  and  religious  be- 
liefs of  the  natives  of  the  country  he  visits.   With  such 
objects  in  view,  there  is  no  country  in  the  world  that 
offers  a  wider  field  and  a  richer  material  than  India. 
As  I  have  indicated  before,  travel  out  of  season  in  a 
tropic  country  offers  advantages  as  well  as  disadvan- 
tages.    Crowding  on  shipboard,  in  railway  carriages  and 
in  hotels  is  avoided.     There  were  only  twenty  first-class 
passengers  on  the  voyage  from  Adelaide  to  Colombo, 
four  from  Colombo  to  Tuticurin  and  less  than  fifty  from 
Bombay  to  Marseilles.   At  Madras,  besides  myself,  there 
was  only  one  guest  in  the  Connemara  Hotel;  at  Calcutta, 
in  the  Great  Western  Hotel,  not  more  than  ten;   at 
Benares  I  had  the  Hotel  de  Paris  to  myself,  so  at  Agra 
tlie  Metropole,  and  at  Delhi  the  Laurie  Hotel,  and  at 
Jaipur,  in  the  Rastum  Family  Hotel,  besides  myself, 
there  was  the  Parsee  woman  doctor  who  will  be  referred 
to  again  further  on.     At  Bombay,  the  magnificent  hotel 
Taj  Mahal,  with  600  rooms,  had  less  than  sixty  guests 
at  the  time  of  my  visit.     The  Indian  railways  provide 
well  for  tlie  first-class  passengers.    The  first-class  com- 
partments have  six  sitting  and  four  lying-down  places, 
lavatory  and  a  connecting  small  compartment  for  serv- 
ants.     Towels   and   bedding   are   carried   by   the   pas- 
sengers.    During  the  six  nights  I  spent  on  th^  train 
I  shared  such  a  convenient  compartment  only  once  with 
a  fellow  traveler,  and  during  the  day  I  was  very  seldom 
disturbed  by  additional  passengers.     I  was  never  obliged 


I  NDIA. 


385 


to  cheek  my  Iriink.  Aviiieli  was  always  broiiglit  into  my 
compartment.  All  trains  carry  ico  and  soda;  the  former 
is  sold  at  4  cenfe;  a  pound  and  the  latter  at  curent  prices. 
The  trains  make  a  stop  of  from  25  to  30  minutes  at 
the  eating  stations  at  tlie  usual  meal  hours  observed 
in  India. 


Fia;.  r)4. — Master  and  servant. 


:\rAs'i'i:]i  and  sekvaxt. 

Tn  undertaking  the  trip  through  India  at  such  an 
unseasonable  time,  I  felt,  for  the  first  time  in  my  life, 
the  need  of  a  personal  attendant  to  relieve  me  of  un- 
necessary care  and  ]ihysical  exertion,  and  on  its  com- 
pletion I  had  every  reason  to  be  satisfied  with  the  step 


286  AROUND    THE    WORLD    VIA    IXDIA. 

I  had  taken.  To  pack  and  to  unpack,  in  a  tempera- 
ture ranging  between  93  and  105  F.  every  day  or  two 
and  to  take  care  of  the  baggage  and  bring  it  from  sta- 
tion to  hotel  and  from  hotel  to  station  in  such  an  un- 
congenial climate,  are  tasks  that  should  be  avoided  by 
the  traveler  and  assigned  to  a  coolie.  At  Colombo  I 
engaged  Lazarus,  a  Ceylonese  Tamil,  about  26  years  of 
age,  who  was  to  accompany  me  as  my  servant  from 
there  to  Bombay.  The  understanding  was  that  I  should 
pay  his  transportation  both  ways,  third-class,  and  that 
he  should  receive  a  rupee  and  a  half  (48  cents)  a  day. 
The  whole  expense  for  the  required  time  amounted  to 
$35.66.      (Fig.  54.) 

Lazarus  was  a  typical  Tamil,  slender,  lithe,  coal- 
black,  with  sharp,  rather  intelligent  eyes.  He  had  a 
wife  and  two  children  and  lived'  near  Colombo.  He  in- 
herited the  Roman  Catholic  faith  and  whenever  we 
visited  a  Catholic  church  he  sprinkled  himself  with 
holy  water  and  made  the  sign  of  the  cross.  A  closer 
acquaintance  with  him,  however,  threw  some  shadows 
on  the  religious  life  of  this  member  of  the  Roman  Catho- 
lic faith.  His  greatest  failing  was  in  money  matters. 
Our  accounts  did  not  always  agree,  but,  as  the  amount 
was  usually  small,  his  bills  were  generally  passed  and 
paid;  however,  as  this  was  a  daily  affair,  I  am  satisfied 
that  some  rupees,  many  annas  and  much  copper  found 
their  way  almost  every  day  into  a  corner  of  his  soiled 
handkerchief  instead  of  back  into  my  pocket.  I  have 
learned  by  a  somewhat  expensive  experience  that  a  pig- 
mented skin  abhors  truth  and  cherishes  to  represent 
things  in  the  ^\^•ong  light,  and  that  whether  yellow  or 
black  its  owner,  heathen  or  convert  can  seldom  be 
depended  on.  I  have  learned  to  comprehend  why  the 
Devil,  the  father  of  lies,  when  pictured,  is  usually 
made  to  appear  in  black.  Questionable  as  the  little 
transactions  of  Lazarus  may  have  been,  his  services 
proved  invaluable  and,  in  the  end,  I  was  the  gainer  so 
far  as  oxpenso  was  concerned.     He  was  a  very  good  ser- 


Fig.  55. — Hindu  butler. 


INDIA.  289 

vanti     I   could  not  lose  anything  if  I  tried.     Things 
that  I  threw  aside  he  would  pick  up  and  repack. 

Lazarus  had  many  unpleasant  functions  to  perfomi. 
Tipping  is  the  curse  of  the  traveler.  This  nuiiiance 
has  reached  greater  dimensions  in  India  than  in  any 
other  country.  Tipping  in  out-of-season  travel  grows 
as  an  unavoidable  evil  in  proportion  as  the  number  of 
visitors  is  diminished.  In  hotels  and  at  railway  sta- 
tions the  number  of  employees  far  exceeded  the  demand, 
and  as  1  was  so  often  the  only  guest  or  first-class  pas- 
senger, all  eyes  and  hands  centered  on  me.  I  made 
Lazarus  my  agent  in  the  distribution  of  tips.  It  was 
he  who  converted  large  silver  coins  into  smaller  change, 
silver  and  copper.  The  coolies  did  not  like  to  deal  with 
me  in  such  an  indirect  way,  but  the  rule  was  an  inflex- 
ible one  and  was  adhered  to  from  the  beginning  to  the 
end  of  the  trip.  It  was  by  this  method  of  disposing 
of  the  tip  nuisance  that  both  I  and  Lazarus  made 
money.  The  coolie,  ignorant  as  he  may  be,  has  learned 
to  distinguish  between  silver  and  copper  and  hates  the 
sight  of  the  latter.  To  pass  through  India  with  honor 
in  the  estimation  of  the  coolie,  it  is  necessary  to  carry 
a  liberal  supply  of  silver  coins  and  to  see  to  it  that  not 
too  many  get  a  hold  of  your  baggage,  as  the  carrying 
of  an  umbrella  or  cane  seems  to  entitle  the  bearer 
to  the  same  financial  consideration  as  is  tendered  to  the 
one  who  groans  under  the  weight  of  the  trunk.  Laz- 
arus was  a  source  of  the  greatest  comfort  to  me.  Ho 
would  inform  me  when  to  prepare  for  the  next  eating 
station  and  when  the  tiuie  came  to  change  cars,  or  the 
approach  of  the  station  where  I  wished  to  interrupt 
the  journey.  He  brought  me  ice  and  soda  whenever  I 
was  tortured  by  thirst,  which  was  often  the  case.  He 
was  master  of  the  Tamil,  Singhalese  and  Hindustani 
languages,  but  his  knowledge  of  English  was  very  lim- 
ited. This  was  perhaps  on  many  occasions  desirable, 
as  he  was  very  loquacious,  like  all  his  countrymen.  He 
would  often  discourse  at  length,  but  at  the  end  I  did 


290  AROUND  THE  WORLD  VIA  INDIA. 

not  know  in  what  language.  Some  of  his  pigeon  Eng- 
lish was  amusing.  In  looking  at  some  wild  peacocks 
one  day,  he  wanted  to  point  out  the  bird  with  the 
brightest  plumage,  and  did  so  by  calling  him  "man  pea- 
cock.^^  His  pronunciation  of  any  of  the  common  Eng- 
lish words  was  so  defective  that  they  were  absolutely 
unintelligibe.  1  had  held  out  to  him  from  the  very 
beginning  the  inducement  tJiat  if  his  services  should 
prove  satisfactory  at  the  end  of  the  trip  he  would  re- 
ceive, besides  his  daily  wages,  some  gold,  and  in  this 
I  did  not  disappoint  him  when  I  bade  him  good  bye  at 
the  Bombay  dock.      (Fig.  55.) 

INDIAN    SUMMER    CLIMATE. 

The  hot  season  in  India  begins  with  the  month  of 
April  and  is  expected  to  end  with  the  month  of  October. 
It  is  said  that  April  and  May  are  the  hottest  and  that 
November,  December  and  January  are  the  coolest 
months  of  the  year.  On  the  way  from  Tuticurin  to 
Madras  the  shade  and  night  temperature  rose  to  98 
F.  and  the  temperature  in  the  sun  to  119  F.  Soon  after 
leaving  Madras  rain  set  in  and  continued  without  inter- 
ruption until  we  reached  Calcutta  and  during  the  first 
day  I  remained  in  that  city.  The  atmosphere  was  sat- 
urated with  humidity  and  added  greatly  to  the  dis- 
comforts and  actual  suffering  from  heat,  although  the 
temperature  at  night  and  in  the  shade  did  not  exceed 
98  F.  The  air  was  not  disturbed  by  the  slightest  breeze, 
it  was  motionless,  paralyzed,  stifling.  Breathing  re- 
quired an  effort  and  the  sweat  jioured  from  the  surface 
when  at  rest. 

"'Heat,  ma'am,'  I  said;  'it  was  so  dreadful  here 
that  I  found  there  was  nothing  left  for  it  but  to 
take  off  mv  flesh  and  sit  in  my  bones.'  "■ — Svdney 
Smith. 

How  often  did  I  envy  those  natives,  with  their  lithe, 
slender,  ratless  bodies  and  their  long  arms  and  legs  and 
flexible  joints.  In  squatting,  the  easiest  resting  posi- 
tion for  these  natives,  the  legs  fold  on  themselves  like 


INDIA.  291 

a  jackknife.  The  agony  I  experienced  from  a  combina- 
tion of  humidity,  heat,  and  the  lazy,  sleeping  air  dur- 
ing the  two  nights  and  day  I  spent  in  Calcutta  would 
be  difficult,  yes,  impossible,  to  describe ;  bathed  in  sweat, 
panting  for  breath,  with  only  partial  relief  from  ice 
and  soda  and  from  vigorous  pulling  of  the  bedrooin 
punkah  throughout  the  night,  by  men  employed  for  that 
purpose. 

A  word  concerning  the  punkah  puller.  Two  men 
or  two  women,  or  one  man  and  one  woman  are  hired 
for  the  night,  and  they  receive  8  cents  each  for  their 
easy  work  and  loss  of  sleep.  One  night  I  had  two  men 
at  the  rope;  about  midnight  the  to-and-fro  motions  of 
the  punkah  became  less  and  less  and  finally  almost  came 
to  a  standstill.  I  went  to  the  door  and  found  one  of 
them  sound  asleep  and  the  other  barely  awake.  The 
slight  jerks  were  directed  by  the  spinal  cord  exclusively ; 
the  brain  was  sleeping.  A  few  sharp  words  brought 
life  to  men  and  punkah. 

I  was  made  to  comprehend  by  a  trying  experience  the 
meaning  of 

"A  dem'd,  damp,  moist,  unpleasant  body." — 
Dickens. 

I  spent  a  whole  forenoon  in  visiting  the  Calcutta 
Medical  College  and  large  government  hospital  con- 
nected with  it,  under  th#  guidance  of  Major  Drury, 
I.M.S.,  principal  of  the  school.  We  inspected  the  labora- 
tories, walked  from  w^ard  to  ward,  climbed  stairs  in- 
numerable and,  although  an  attendant  with  an  enor- 
mous fan  accompanied  us  and  gave  us  the  full  benefit 
of  the  useful  article,  I  soon  felt  the  sweat  running  in 
streams  down  my  legs  and  into  my  shoes  and,  in  spite 
of  frequent  wiping  of  face  and  neck,  the  collar  soon 
w^ilted  into  a  shapeless  rag.  It  was  then  it  occurred  to 
me: 

"Ay,  now  am  I  in  Arden;  the  more  fool  I. 
When  I  was  at  home  I  was  in  a  good  place,  but 
travelers  must  be  content." — Shakespeare. 


292  AROUND    THE    WORLD   VIA    INDIA. 

For  once  I  was  glad  when  the  visit  was  at  an  end 
and  the  courteous  major  took  me  to  his  private  apart- 
ments^ where  a  most  luxurious  breakfast  was  served 
and  where  my  torturing  thirst  was  quenched  with  ice 
and  claret.  As  soon  as  we  arrived  in  the  room,  the  ma- 
jor suggested  that  I  should  make  myself  more  comfort- 
able by  removing  the  coat.  I  did  so  most  willingly 
and  then  discovered  to  what  extent  the  clothing  had 
become  saturated  by  the  profuse  sweating.  Judged 
by  the  clotliing.  and  found  near  the  Ganges,  the  sus- 
picion would  hare  been  well  founded  that  I  had  been 
rescued  a  few  moments  ago  from  drowning  in  the  sacred 
river.  Without  rain  ajid  sweating  the  clothing  would 
become  moist  from  the  excessive  humidit}^  of  the  atmos- 
phere. What  discomfort  and  annoyance  this  creates. 
Try  under  such  circumstances  to  fetch  in  a  hurry  from 
the  wet  trousers  pocket  with  a  sweating  hand  a  coin 
for  a  tip  and  you  will  find  that  the  pocket  becomes  a 
veritable  trap  for  the  hand,  Avhich  is  with  difficulty 
extricated  without  everting  the  pocket  and  scattering 
the  coins. 

It  seemed  to  me  strange  that  the  temperature  in- 
creased as  I  traveled  north,  but  in  leaving  the  coast  the 
humidity  gradually  diminished,  and  in  the  interior  the 
air  was  comparatively  dry.  The  thermometer  I  car- 
ried with  me  registered  132  P.;  on  several  occasions  the 
mercury  reached  the  maximum  limit  of  the  instrument 
in  the  sun  and  would  undoubtedly  have  gone  higher  had 
there  been  additional  space.  This  high  temperature  was 
registered  at  Agra,  Delhi  and  Jaipur.  The  night  and 
shade  temperature  on  the  whole  trip  from  Calcutta  to 
Bombay  ranged  between  92  to  105  F.  The  Bombay 
weather  was  very  much  like  that  of  Calcutta,  rain  and 
humidity,  but  the  temperature  was  a  little  lower  and 
occasional  breezes  diminished  the  sweating  and  relieved 
the  intense  sense  of  heat. 

All  through  India  the  absence  of  a  breeze  made  the 
heat  distressing.     Some   davs   about   4   o'clock  in   the 


INDIA.  293 

afternoon  a  slight  agitation  of  the  atmosphere  woulil 
begin,  enough  to  shake  slightly  the  leaves  of  the  omni- 
present nim  trees  and  would  bring  with  it  a  decided 
relief,  but  even  this  slight  attempt  on  the  part  of  the 
atmosphere  to  counteract  the  effect  of  the  burning  sun 
was  alwa)'s  of  short  duration.  It  was  interesting  to 
observe  how  the  animals,  wild  and  domestic,  behaved 
during  the  hottest  part  of  the  day.  The  water  buffalo 
is  a  great  batlier  and  he  is  not  particular  about  the 
nature  of  the  bath;  if  he  has  any  preference,  it  is  for 
the  mud  bath.  In  passing  the  many  water  and  mud 
holes  along  the  line  of  the  railroad,  I  have  often  seen 
through  the  car  window  two  long,  flat,  reclining  horns 
and  a  pair  of  sleepy  or  closed  eyes  just  above  the  level 
of  the  mud  or  water,  and  in  looking  closer  might  dis- 
tinguish back  of  them  the  ridge  of  the  spine,  the  bal- 
ance of  the  body  being  completely  immersed.  The 
buffalo  has  three  objects  in  view  when  he  goes  bathing: 
To  rid  himself  for  the  time  being  of  pestering  insects, 
to  gain  relief  from  the  intense  heat  and  to  obtain 
a  sootliing  rest  after  his  liberation  from  the  hard,  piim- 
itive  yoke.  Sometimes  we  saw  a  herd  of  tliese  animals 
closely  packed  in  a  small  pool  or  mud  hole.  They  are 
peaceable,  tolerant  animals,  so  that  even  when  standing 
space  is  scarce,  these  animals  of  burden  make  room  for 
each  other  without  the  slightest  indication  of  selfl.-^hness. 
I  fancy  that  the  water  buffalo  prefers  mud  t.o  water  for 
his  bath,  for  it  leaves  a  thick  layer  of  mud  on  the  sur- 
face of  his  body,  which  soon  dries  into  a  crust,  a  fur- 
ther protection  against  flies  and  mosquitoes.  The  bul- 
locks, sheep  and  goats  seek  the  shade  of  trees  during 
the  hottest  part  of  the  day,  and  if  the  trees  are  few 
and  the  animals  numerous,  every  inch  of  it  is  made 
useful,  and,  as  the  shade  moves,  the  family  of  animals 
shifts  in  the  same  direction  to  protect  themselves  against 
the  scorching  rays  of  the  sun. 

The  proud,   wild  peacock,   so  numerous  all  through 
India,  but  more  especially  in  the  eastern  part,  forgets 


394  AKOUXD  THE  WORLD  VIA  INDIA. 

for  a  time  his  vanity  Avhen  the  sun  is  in  a  position  to 
send  down  on  poor  India  its  most  scorching  rays.  He 
folds  and  hangs  liis  gaudy  tail  and  sneaks  away  into  the 
shade  of  a  clump  of  shrubs  or  cactus  hedge  and  lowers 
his  microcephalic  head  with  half  closed  eyes  in  obedience 
to  his  majesty  of  the  day.  India  swarms  with  turtle 
doves  and  the  telegraph  wires  are  their  favorite  perch. 
In  many  stretches  of  the  country  from  one  to  a  dozen  of 
these  tidy,  innocent  birds  can  be  seen  perched  on  a  wire 
between  two  telegraph  post.s  as  the  train  rushes  by. 
When  the  temperature  rises  to  130  F.  and  more,  ^he 
wires  become  too  hot  for  their  tiny  red  feet  and  they 
are  driven  by  the  heat  to  find  protection  in  the  shade. 

Man  appears  to  possess  the  greatest  resisting  power 
against  heat.  The  coolie,  bareheaded  or  with  a  few 
yards  of  cotton  cloth  wrapped  about  his  head  in  the 
fonn  of  a  turban,  can  be  seen  at  work  any  time  of  the 
day,  no  matter  what  the  thermometer  may  say.  From 
early  morning  until  late  at  night  he  toils  in  the  llelds, 
plowing,  sowing,  harvesting,  or  dipping  water,  as  the 
case  may  be,  to  earn  his  scanty  livelihood.  In  many 
parts  of  India  the  month  of  September  is  the  most  try- 
ing one.  My  guide  at  Delhi  called  it  the  "sickness 
month,"  and  informed  me  that  during  this  month  few 
escaped  fever,  which  w^ould  last  from  one  to  several 
days.     I  presume  a  mild  form  of  malaria. 

The  insects  were  not  so  troublesome  as  I  expected. 
At  Jaipur  the  flies  were  numerous  and  aggressive.  Id 
the  hotel  at  Calcutta  I  found  my  bed  screened  with  mos- 
quito bar.  As  the  evening  was  extremely  sultry  and 
as  I  heard  no  mosquito  music,  I  removed  it.  Next 
morning  I  found  the  uncovered  part  of  my  body  check- 
ered with  ugly  mosquito  bites,  the  noiseless  minute 
mosquito  had  deceived  me  and  wrought  the  mischief 
during  the  few  snatches  of  sleep  that  came  to  me  that 
awful  night.  I  am  glad  that  I  have  seen  India  at  its 
worst,  so  far  as  the  climate  is  concerned,  and  that  I 
have  escaped  with  my  life,  and  my  health  unimpaired, 


Fig.  5G. — An  Indian  faquer. 


Fig.  57. — An  Arab  Jew  in  India. 


INDIA.  299 

but  I  will  never  advise  any  of  my  friends  to  go  through 
a  similar  experience,  as  it  involves  great  suffering  and 
is  attended  by  no  inconsiderable  immediate  and  remoU; 
risk  to  life. 

THE   PEOPLE. 

India  has,  approximately,  300,000,000  inliabitants, 
four  to  one  of  the  United  States  The  population  is  a 
very  mixed  one,  composed  of  Hindus,  Afghans,  Moham- 
medans, Parsees,  Thibetans,  and  other  Asiatic  races. 
Europeans  and  Asiatics,  called  here  Eurasians,  in  Ceylon 
half-castes.  The  original  East  Indians  were  an  Aryan 
race,  which  came  from  Central  Asia  by  way  of  the  Cabul 
I'iver.  The  present  Iliiidi;  race  represents  Aryan  and 
non-Ar}'an  elements.  The  typical  Hindu  is  above  av- 
erage size,  fine,  erect,  slender  physique,  long,  very  tliin 
legs  and  arms,  straight  black  hair,  beard  of  the  same 
color,  light  or  heavy.  The  color  of  the  skin  varies  from 
yellow  to  coal  black.  (Fig.  50.)  Many  of  the  men  are 
handsome;  others,  especially  the  common  coolies,  are 
often  not  only  ugly  but  absolutely  hideous,  their  faces 
approaching  the  appearance  of  a  monkey  rather  than 
that  of  a  man.  The  women  are  homely  almost  without 
exception;  much  smaller  than  the  men  and  very  spare 
even  during  old  age. 

The  handsomest  men  and  women  are  found  among 
the  Parsees,  the  fire  worshipers,  who  came  from  Persia 
to  India  centuries  ago.  They  are  a  thrifty  people,  fond 
of  dress.  The  men  wear  a  very  strange  head  covering, 
which  does  not  answer  to  the  description  of  either  a 
hat  or  cap.  Imagine  a  black  piece  of  stovepipe  a  foot 
in  length,  speckled  with  minute  yellow  dots,  and  turn 
in  the  top  obliquely  and  you  have  as  complete  a  descrip- 
tion of  the  headdress  of  the  Parsee  as  can  be  given  in 
words.  The  women  are  dressed  in  flowing  silk  of  vivid 
colors,  and  display  a  wealth  of  jewels  attached  to  ears, 
neck,  fingers  and  wrists.  Bombay  is  the  center  of  the 
Parsee  population,  about  100,000  in  number.  Their 
principal  temple  and  ghastly  graveyard  are  located  here. 


# 


300  AROUND    THE    WORLD    VIA    INDIA. 

Social  distinction  is  drawn  in  India  in  more  definite 
lines  than  in  any  other  country.  It  is  a  land  of  castes. 
There  are  more  than  1,000  of  these  castes,  which  have 
very  little  in  common  with  each  other.  The  Brahmins 
or  priests  take  the  first  rank,  the  warriors  the  second, 
and  the  merchants  the  third,  then  follow  the  different 
professions  and  trades.  The  caste  of  warriors  is  the  only 
one  which  is  permitted  to  hunt  and  to  eat  meat.  There 
is  never  an  intermarriage  between  a  high  caste  man  or 
woman  with  a  lower  caste  woman  or  man,  but  in  excep- 
tional cases  a  promotion  from  a  lower  to  a  higher  caste 
with  all  privileges  belonging  to  such  advancement  may 
take  place.  The  lower  castes  made  themselves  known 
by  stripes  and  dots  of  all  colors  and  designs  on  the  fore- 
head or  face.  A  study  of  these  distinctive  marks  would 
prove  a  very  thankless  task  to  the  foreigner  owing  to 
the  endless  number  of  castes. 

The  religious  life  in  India  is  as  mixed  as  its  popula- 
tion. In  1891  there  were  207,731,727  Brahma  fol- 
lowers, 7,131,361  Buddhists,  »57,331,164  Mohanunedans, 
and  only  2,284,380  Christians,  a  rather  discouraging 
showing  for  the  millions  and  millions  of  dollars  that 
have  been  spent  in  efforts  to  christianize  the  people.  The 
slow  progress  of  Christianity  in  India  is  due,  at  least  in 
part,  to  the  character  of  the  people.  The  complicated 
class  distinction  is  one  of  the  greatest  obstacles.  The 
high  caste  Hindu  prides  himself  on  the  antiquity  oL* 
his  religion.     He  is  firmly  convinced  that: 

"Antiquity,  the  nearer  it  was  to  its  divine  ori- 
gin, perhaps  perceived  more  clearly  what  things 
were  true." — Cicero. 
A  high-caste  Hindu,  a  very  learned  man,  a  magistrate 
in  one  of  the  eastern  districts  of  India,  expressed  him- 
self to  me  on  this  subject  about  as  follows:    "My  relig- 
ion is  the  oldest  in  the  w^orld.     It  was  old  before  the 
religion   of   the   Christians   was   known.     I   spent  five 
years  in  England.     I  made  careful  observations  and  in 
consequence  came  to  the  conclusion  that  my  people  are 
better  people  than  the  people  I  observed  in  England. 


!•  li'urt 


INDIA.  303 

Crime  is  more  common  in  England  than  in  India.  Why 
should  I  change  my  religion?  The  essence  of  our  re- 
ligion consists  in  leading  a  useful,  pure  life.  We  believe 
in  progression  in  spiritual  as  well  as  in  worldly  affairs. 
As  the  muscle  is  strengthened  by  exercise,  so  constant 
efforts  to  reach  a  higher  spiritual  existence  will  improve 
progressively  the  spiritual  part  of  men  until  perfection 
is  reached.  We  do  not  believe  in  perpetual  punishment 
after  deatli,  but  in  a  gradual  elevation  until  nirvana,  a 
state  of  perfection,  is  attained.  Missionaries  can  not 
change  the  religious  views  of  high  caste  Hindus.  Then, 
too,  the  manner  of  living  and  the  way  in  which  the 
missionaries  approach  the  low  caste  Hindus  are  not  cal- 
culated to  excite  their  interest  or  to  gain  their  con- 
fidence."    This  is  what  the  Hindu  said. 

In  conversation  with  me  a  Eoman  Catholic  priest 
who  came  to  India  26  years  ago  said :  "We  can  do 
nothing  with  the  adults  in  the  way  of  converting  them. 
The  people  appreciate  our  works  of  charity  and  our 
efforts  to  educate  their  children.  We  must  plant  the 
seed  of  true  religion  in  the  hearts  of  the  cliildren,  where 
it  will  grow,  but  their  parents  are  out  of  our  reach. 
The  high  caste,  educated  Hindus  have  their  fixed  re- 
ligious ideas  from  which  they  can  not  be  diverted,  and 
the  low  castes  are  in  the  firm  grasp  of  the  Brahmin  and 
the  Buddhist  priests." 

The  natives  are  susipicious  of  the  Europeans  and  are 
naturally  proud  and  not  easily  approached.  The  poor- 
est of  the  poor  possess  an  inborn  pride  and  manifest  a 
spirit  of  reserve  entirely  unknown  among  the  South 
Sea  Islanders.  There  is  no  "Alohanui"  or  "Talofa" 
greeting  xor  the  stranger  in  India.  The  faces  are  stern, 
the  look  shy.  the  bearing  defiant  and  smiles  few  imless 
they  are  provoked  by  a  liberal  tip.  The  converted  na- 
tives may  conform  on  the  surface  witli  the  teachings 
of  the  church  to  which  they  belong,  but  in  their  inner 
life  they  retain  much  of  what  they  have  been  taught, 
and  what  they  practiced  before  they  changed  their  re- 


304  AKOUXD  THE  AVORLD  VIA   INDIA. 

ligioiis  views;  we  can  say  of  them  as  well  as  of  their 

heathen  brethren: 

"Some  are  good,  some  are  middling,  the  greater 
part  are  bad." — ilartialis. 

"Habit  has  produced  the  custom." — Ovidius. 

Missionary  work  has  done  more  good  in  supplying  the 
starving  ^dth  food,  the  sick  with  nursing  and  with  medi- 
cal treatment,  the  poor  with  clothing  and  in  the  educa- 
tion of  children  than  in  the  christianization  of  the  peo- 
ple.    The  door  to  the  heart  of  the  Hindu  is  charity. 

The  greatest  .virtue  of  the  coolie  is  his  ^nllingness  to 
work.  It  is  the  coolie  who  cultivates  the  fields,  loads 
and  unloads  vessels  and  cars,  cleans  the  streets,  empties 
the  cesspools  and  performs  all  other  menial  work,  for 
wages  which  range  from  8  to  32  cents  a  day.  He  has 
held  his  place  in  the  competition  for  cheap  labor  against 
Chinese  and  Japanese,  and  against  cheap  workmen  from 
other  parts  of  the  world.  He  meets  the  demand  for 
labor  in  India  and  the  low  wages  with  which  he  is  con- 
tent have  so  far  efEectually  prevented  outside  competi- 
tion, and  owing  to  the  dense  population  and  the  severe 
struggle  for  existence  which  are  in  evidence  everywhere, 
preclude  the  idea  of  a  possible  betterment  of  the  condi- 
tion of  the  laboring  classes.  The  coolie  has  no  desire 
to  accumulate  wealth ;  he  is  satisfied  if  by  hard  toil  he 
is  able  to  keep  the  wolf  from  the  door.  His  needs  are 
few,  and  what  many  a  Chicago  family  spends  every 
day  for  newspapers  will  support  himself,  his  wife  and 
children.     From  experience  he  can  say: 

"Ye  immortal  gods,  men  know  not  how  great  a 
revenue  economy  is." — Cicero. 

INDIAN   ART. 

India  is  a  gTcat  ait  mnsoum.  Tbe  ancient  palaces, 
temples  and  tombs  are  the  silent  witnesses  of  the  exqui- 
site workmanship  of  native  artists,  who  lived  and  worked 
here  centuries  before  Solomon's  temple  was  built.  The 
masonry  of  many  of  tliese  remnants  of  ancient  archi- 
tecture is  the  wonder  of  the  leaders  of  the  craft  to-day. 


Fig.   59. — A     Sikh   Priest. 


i'iii.    (;u. — Low   Caste   Hindu    (Jiils. 


INDIA.  309 

Tlu'  size  oL'  the  stones,  the  cutting,  placing  tliciii  in  posi- 
tion, the  fitting  them  together  with  such  accuracy  that 
cement  of  any  Icind  was  superfluous,  in  other  instances 
the  fitting  together  with  metallic  substances,  are  lost 
arts.  The  designs  of  the  mosaics,  the  sculpturing  and 
the  wood  carvings,  the  inlaid  work  are  marvels  of  skill, 
patience  and  persevereiu-e.  Tlie  ancient  artist  and  arti- 
san made  use  of  noble  material  on  which  to  stamp  indel- 
ibly the  proofs  of  his  skill.  In  short,  nature  supplies  the 
material,    art   works   on   it. 

"Art  can  effect  nothing  without  material,  yet 
there  is  an  inherent  value  in  material,  though  un- 
touched by  the  art  of  man.  Perfection  of  art  is 
superior  to  the  best  material." — Quintilianus. 

Symmetry  was  above  everything  else  the  object  of  the 
ancient  architecture,  mosaics,  columns  and  arches  were 
the  details  in  canning  out  his  designs.  The  two  pieces 
of  architecture  and  design  that  impressed  me  most  were 
the  royal  tomb,  Taj  Mahal  at  Agra  and  the  Cave 
Temple  in  Elephanta  Island  near  Bombay,  the  former 
noted  for  its  exquisite  beauty,  the  latter  for  its  great 
age  and  wonderful  mural  statues,  cut  out  of  the  hard 
rock,  to  which  allusion  will  again  be  made  further  on. 

It  is  a  source  of  great  regret  tliat  the  influential  and 
rich  natives  take  so  little  interest  in  the  preservation 
and  maintenance  of  their  works  of  art,  which  after  all, 
are  tlie  great  magnets  that  attract  thousands  of  visitors 
to  India  annually.  Palaces  and  palatial  residences  are 
now  being  built  in  imitation  of  what  they  have  seen 
abroad.  Painters  from  Italy  and  France  do  the  dec- 
orating. Plush  and  silk  covered  furniture  is  brouglit 
from  Europe,  and  the  old  beautifully  carved  chairs, 
tables  and  other  articles  of  furniture  are  stored  away, 
sold  for  a  song  or  given  away  to  make  room  for  things 
that  are  not  adapted  to  the  climate  aud  that  can  make 
no  pretention  to  art.  It  is  very  fortunate  that  Lard 
Curzon  has  taken  the  necessary  steps  to  preserve  Indian 
art  by  the  erection  of  a  great  museum  of  art  in  Calcutta, 
in  blessed  memory  of  the  late  Empress  Victoria,  where 


310  AROUND  THE  WORLD  VIA  INDIA. 

tlie  most  valuable  and  interesting  specimens  will  find 
a  permanent  resting  place  for  the  benefit  of  future  gen- 
erations of  natives  and  visitors. 

It  is  high  time  that  in  the  three  great  cities  of  Cal- 
cutta, Bombay,  and  Madras,  associations  of  Indian  art 
should  be  founded  for  the  purpose  of  collecting  and  pre- 
serving specimens  of  ancient  Indian  art,  and  with  the 
object  of  encouraging  the  native  artists  of  to-day  by 
patronizing  them  instead  of  importing  furniture  from 
foreign  countries  and  imitating  the  artless  style  of  the 
Iniildings  of  the  Europeans.  For  the  benefit  of  natives 
as  well  as  of  travelers,  India  should  remain  specifically 
Indian  in  dress,  customs,  agriculture,  and  especially  in 
art. 

NOTABLE   MEDICINAL  TREES    OF  INDIA. 

On  landing  at  Tuticurin  I  came  faCc  to  face  with  two 
trees  that  I  never  lost  sight  of  on  my  long  railway 
journe}^ — the  palmyra  palm  and  the  nun  tree.  The 
palmyra  23alm  (BoJ'assus  f,ahelliformis)  is  a  hardy,  noble 
tree,  and  attains  a  heiglit  of  100  feet.  The  base  of 
the  stem  is  large  and  gradually  tapers  into  the  stem 
proper,  which  has  a  unifonn  thickness  up  to  the  very 
crown.  The  bark  is  almost  black  and  indented  with  cir- 
cular rings.  The  crown  of  fronds  is  small  compared 
with  the  size  of  the  tree.  In  southern  India  the  leaves 
are  used  for  roofing,  and  nearly  all  the  trees  have  been 
pruned  down  to  six  or  eight  fronds.  The  pulp  of  the 
fruit  serves  as  food.  Enormous  masses  of  sugar  and 
toddy  are  produced  in  India  from  the  sap  which  flows 
from  incisions  of  the  stalk  of  the  nnexpanded  flowers. 
This  tree  is  noted  for  its  longevity,  and  trees  200  years 
old  are  by  not  means  rare.  The  Mohammedans  are 
supposed  to  be  total  abstainers,  but  not  invariably  so, 
as  I  learned  from  a  little  story  related  to  me  in  India. 
A  man  who  owned  a  number  of  these  palm  trees,  and 
who  had  bled  them  for  the  purpose  of  supplying  himself 
with  the  much  cherished  toddy,  noticed  that  much  of 


i 

nf>    i^^ 

i^ 

"^  h^                                ^^^B^^^^H 

ki8iJ|r":i 

jH 

H 

^ 

m'. 

Rft 

WL 

'4^     ' 

iP^"'"^;*' 

HB . 

?, 

|p^ 

-  ;tr^^ 

H 

M     .{^1^ 

iii  • 

■B^ 

^ 

^ 

S^mW- 

"'ML—    flr  '*'       Vj^B 

Fig.   61. — An   Illustratioa  of   Hindu   Architecture. 


INDIA.  315 

tlie  ])reei()iis  juice  disappeared  iiiysterioiislv  during  the 
night.  Xot  suspecting  tliat  tlie  pilfering  was  done  by 
liuman  beings  he  poured  tincture  of  aconite  into  tlic  cuts 
into  which  the  sap  accumuhited.  The  next  morning  on 
going  for  liis  toddy  lie  found  to  Ids  utter  astonishment 
two  followers  of  the  prophet  dead  near  the  tree  and  sev- 
eral more  very  sick  in  an  adjacent  thicket.  For  ob- 
vious reasons  a  judicial  investigation  was  not  applied 
for.  The  leaves  of  this  palm  have  been  used  for  cen- 
turies as  writing  paper. 

The  nim  tree  (Melia  azadiracMci)  is  one  of  the  most 
beautiful  and  useful  trees  of  India.  It  attains  a  height 
of  50  feet,  has  a  short,  black  barked  stem,  strong,  widely 
spreading  branches  and  a  dark,  fresh  green,  rich  foliage 
of  long  feathery  leaves.  At  Jaipur  I  saw  a  boy  climb 
one  of  these  trees,  and  with  pruning  scissors  sever 
enough  of  its  leaves  to  feed  a  flock  of  sheep  which  had 
gathered  around  the  base  of  the  tree,  anj^iously  await- 
ing the  expected  fodder.  The  leaves  have  a  great  repu- 
tation as  a  remedy  for  dysenter}'  and  malaria.  Many 
M'onderful  stories  have  I  heard  concerning  the  curative 
powers  of  a  decoction  of  the  leaves  of  the  nim  tree. 
I^his  popular  reputation  is  sustained  by  tlie  medical 
profession. 

The  tamarind  {Tamarindus  indica)  is  a  magnificent, 
large,  expansive  tree.  It  is  one  of  the  largest  trees  of 
southern  India.  x\n  immense  tamarind  tree  is  in  the 
court  of  the  monkey  temple  at  Benares,  and  it  is  in.  this 
tree  that  the  monkeys  take  their  gymnastic  exercises. 
The  monkeys  are  anxiously  awaiting  the  ripening  of 
its  fruit.  The  acid  pulp  of  the  long  pods  forms  the 
medicinal  tamarind,  rich  in  formic  and  butyric  acid, 
irrespective  of  its  other  contents,  cold  made  into  a  syrup, 
it  can  be  kept  for  preparing  a  palatable  acidulous  drink. 

The  babal  or  gum  arable  tree  (Acaci-a-  arahica)  is  a 
very  common  tree  in  India.  It  is  a  small  tree  and  is 
used  sometimes  for  thorny  hedges.  Occasionally  the 
stem  attains  a  circumference  of  10  feet.     It  furnishes 


316  AROUND    THE    WORLD    VIA   INDIA. 

one  of  the  Ijest  kinds  of  gum  arable  for  medicinal  and 
technical  purposes.  Cattle  are  fond  of  its  leaves.  The 
Avood  is  hard  and  duralile,  and  the  pods  and  bark  are 
used  for  tanning. 

One  of  the  most  interesting  trees  to  be  found  in 
India,  although  without  medical  interest,  is  the  banyan 
tree  (Ficus  hengalensis) .  While  at  Calcutta  I  made  a 
special  pilgrimage  to  see  the  famous  banyan  tree  in  the 
Botanical  Garden,  six  miles  from  the  center  of  the  city. 
A  label  attached  to  the  stem  of  the  mother  tree  bears 
the  folloA\ang  legend:  "This  tree  is  about  135  years 
old;  the  circumference  of  its  trunk,  at  about  51/0  feet 
from  the  ground,  is  51  feet,  and  of  its  crown  about 
938  feet.  It  has  464  aerial  roots  actually  rooted  in 
the  ground."  The  sight  of  this  veteran  of  the  Botanical 
Garden  is  inspiring.  The  daughter  trees  form  a  cir- 
cular colonnade  and  their  interweaving  branches  a  roof 
under  which  a  whole  regiment  of  soldiers  would  find 
an  ample  camping  ground.  The  mother  tree  shows 
signs  of  far  advanced  senile  decay,  but  her  offspring 
have  gained  an  independent  existence  and  will  keep  her 
memory  fresh  for  many  generations  to  come.  Since  I 
saw  this  wonder  of  the  Indian  forests  I  have  learned 
that  the  banyan  tree  at  Ahemabad  is  still  larger  and 
the  largest  in  the  world.  Had  I  known  this  hefore  I 
would  have  intercepted  my  itinerary  at  that  ancient  city. 

For  technical  purposes,  the  most  valuable  tree  in 
India  is  the  teak  tree  {Tectona  grandis).  It  is  a  su- 
perl)  timber  tree.  It  sheds  its  very  large  leaves  annual- 
ly. Teakwood  is  held  in  the  highest  esteem  by  ship- 
builders; for  the  backing  of  ironclad  men-of-war  it  is 
preferred  to  any  other  wood;  also  for  the  panels  of 
coaches  and  inside  finishing  of  houses,  and  for  various 
other  select  purposes.  The  wood  is  extremely  hard 
and  scarcely  shrinks.  This  wood  is  sold  in  London  at 
$75  per  50  cubic  feet. 

The  siris-acacia  (Alhizzia  Lelhech)  is  a  very  com- 
mon and  beautiful  shade  tree.     It  produces  also  a  good 


INDIA.  319 

deal  of  useful  gum.  The  blossoms  are  much  i^ought 
by  honey  heea,  as  tlieir  pollen  is  rich  in  honey-produc- 
ing material. 

15KNAIiES  MOXKEY  TEMPLE. 

Among  the  maiiy  things  which  interest  the  traveler 
at  Benares  is  the  JMonkey  Temple.  Within  the  walled 
enclosure  surrounding  tlie  temple  is  an  immense  tank 
which  collects  the  rainwater.  From  the  tank  a  series 
of  wide  stone  steps  lead  to  the  famous  temple.  On 
entering  the  temple,  we  were  met  by  the  chief  priest, 
Sree  Swayam  Prakashhashanand  Maithila  Auland  Bag, 
the  successor  of  the  Benares  saint  recently  deceased. 
His  dress  did  not  indicate  his  high  Brahmin  position. 
It  consisted  of  a  loin  cloth  and  a  few  yards  of  yellow 
calico  with  \\'hich  to  obscure  the  left  arm  and  a  very 
limited  part  of  the  chest.  His  short-cropped,  grizzly 
hair  and  beard  did  not  add  much  to  his  clerical  appear- 
ance. 

The  moment  we  entered  half  a  dozen  young  priests 
who  surrounded  him  howled  at  the  top  of  their  voices, 
''How,  how,  how."  I  thought  I  had  committed  a  Ijlunder 
by  entering  the  sanctuary  in  my  mud-stained  shoes. 
This  was  not  the  case.  It  was  a  priestly  greeting  and 
a  call  for  the  monkeys,  which  came  running  from  all 
directions,  knowing  Avell  that  the  call  meant  the  ar- 
rival of  a  stranger  who  would  be  willing  to  part  with 
a  few  small  silver  coins,  with  some  of  which  the  good 
priests  would  buy  food  for  them  wdiicli  they  expected 
to  eat  in  the  presence  of  tlie  visitor.  They  had  cal- 
culated right;  their  expectations  were  realized.  These 
miserabJe,  treacherous,  thievish,  filthy  beasts  occupy  a 
high  position  as  objects  of  worship  by  the  Hindus.  To 
maltreat  a  monJcey  constitutes,  in  their  estimation,  a 
greater  crime  than  the  killing  of  a  coolie.  The  mon- 
keys in  this  temple  are  the  same  as  herds  of  monkeys 
in  and  all  around  Jaipur.  They  are  very  large,  gray, 
witii    black     faces,    and    tails    as    loni;;    and    thick    as 


320 


AROUND  THE   WORLD  VIA  IXDIA. 


broom  handles.  In  a  few  moments  we  were  sui-rounded 
by  a  large  crowd  of  these  pets  of  the  priest,  with  whom 
they  axe  very  familiar,  but  they  mistrust  the  white 
man  and  remain  at  a  respectable  distance  from  him. 
They  eagerly  devoured  the  proffered  food,  roasted  peas 
and  small  crackers.  The  majestic  tamarind  tree  be- 
hind the  temple  was  alive  with  monkeys  of  all  sizes 


Fig.   Gl. — Swami   lihaskaia   Xaud   Saraswati,   the  famous  Ascetic 
of  Benares. 


and  ages.  Veteran  monkeys  of  doubtful  age  and  baby 
monkeys  on  the  backs  of  their  mothers,  were  all  equally 
anxious  to  l)e  benefited  by  the  lil)erality  of  the  visitor, 
as  visitors  during  this  season  of  tlie  3'ear  are  of  rare 
occurrence.  There  are  more  than  300  of  these  monkey 
gods  in  this  temple. 


INDIA.  323' 

A    BENAKES    SAINT. 

The  priest  to  -whom  I  have  first  referred  is,  as  he 
claims,  the  legitimate^  successor  to  the  Benares  Saint, 
Swami  Bhaskara  Xand  Saraswati.  ■  (Fig.  64.)  He  has 
the  advantage  over  his  predecessor  in  the  greater  length 
of  his  name.  The  saint,  or,  as  his  successor  calls  him, 
"Holy  Sage,"  died  a  few  years  ago  and  I  visited  his 
plain  tomb  near  the  temple.  He  was  for  many  years 
a  familiar  Benares  character.  His  deep  learning,  plain 
manner  of  living  and  ascetic  dispositon  made  him  prom- 
inent in  the  priesthood  and  an  object  of  curiosity  to 
the  visitors.  He  was  born  in  the  year  1833.  He  was  in- 
vested with  the  sacred  thread  when  he  was  8  years  old. 
He  married  at  the  age  of  12  but  left  no  issue,  although 
a  son  had  been  born  to  him.  Soon  after  the  birth  of  his 
child  he  left  his  home  and  wife  and  devoted  himself  to 
the  study  of  Sanscrit,  visited  shrines  and  became  known 
to  all  as  a  profound  Sanscrit  scholar,  a  philosopher  and 
a  real  Yogi.  His  successor  says  of  him:  "His  dignified 
mein  and  venerable  face  silenced  the  onlookers  who  had 
doubted  that  a  man  could  learn  and  practice  Yoga  at 
such  an  early  age."  And  again,  "His  soul  penetrated  in- 
to the  very  heart  of  Being,  by  seeing  reality  as  it  is.  He 
was  a  philosopher  to  whom  God  was  not  merely  the 
creator  of  this  universe,  its  protector  and  guide,  but 
the  life  of  his  life,  the  soul  of  his  soul — ^liis  very  self. 
Such  a  sage  was  the  Swami  Bhaskara  Xand — calm, 
silent,  majestic,  immersed  in  the  glon^  of  his  ovra  soul."' 
What  an  enviable  record  to  leave  in  this  world  of  sin 
and  corrpution. 

IIIXDU    CREMATION. 

Sitting  on  the  deck  of  a  river  rowboat  and  gliding 
down  the  sacred  Ganges  near  its  border  on  the  side  of 
the  ancient  city  of  Benares,  we  passed  tlie  principal 
temple.  A  saw  a  number  of  burning  funeral  pyres  at 
the  very  edge  of  the  turbulent,  dirty  stream.  It  was 
too  late  to  see  the  whole  process  of  cremation  as  prac- 
ticed by  the  Hindus.     It  was  at  Agra  that  I  was  given 


324  AROUND    THE    WORLD   VIA    INDIA. 

an  opportunity  to  become  a  witness  of  this  funeral  rite. 
On  the  way  to  tjae  Taj  Mahal  we  passed  a  small  pro- 
cession, following  a  corpse  carried  on  a  litter  of  dry 
bamboo  sticks  on  the  shoulders  of  four  men.  The  corpse 
was  covered  with  a  cloth  of  bright  colors,  red  being 
the  predominating  one.  The  Avhole  procession  was 
made  up  of  men,  24  in  number.  Women  never  attend 
funerals.  The  procession  moved  in  quick  steps  and 
the  mourners  chanted  a  monotonous  dirge,  re|>eating 
over  and  over  the  same  words,  which  the  guide  trans- 
lated into  "The  name  of  God  is  true."  Wishing  to 
profit  by  this  opportunity  to  witness  an  open-air  crema- 
tion, I  abandoned,  for  the  time  being,  the  visit  to  the  Taj 
Mahal  and  followed  the  procession.  The  procession 
continued  its  march  until  the  border  of  the  Jumna 
River  was  reached,  where  the  corpse  resting  on  the 
bamboo  litter  was  deposited  on  the  ground.  I  learned 
that  the  body  was  the  corpse  of  a  married  coolie  woman, 
25  years  old.  She  was  sick  15  days  with  a  diffuse 
swelling  of  the  face  (erysipelas?),  and  had  died  at  5 
o'clock  in  the  morning  of  the  same  day.  It  was  now 
9  a.  m.  Her  husband  was  working  in  a  place  in  the 
country,  20  miles  from  the  city,  and  knew  nothing  of 
her  illness  and  death.  The  only  relative  present  was 
a  brother,  a  lad  about  17  years  old,  who  officiated  at 
the  ceremony.  The  people  were  evidently  extremely 
poor,  so  economy  had  to  be  practiced  in  cremating  the 
corpse.  The  men  squatted  in  a  group  on  the  banks 
of  the  river,  smoked  and  chatted,  and  nothing  but  the 
presence  of  the  corpse  and  the  materials  for  building 
a  fire  reminded  us  that  we  were  in  the  presence  of  death. 
The  young  brother  was  the  onjy  one  whose  face  was 
earnest  and  expressive  of  grief,  but  not  a  tear  was  to 
be  seen.  Wood  is  very  expensive  in  India,  14  pi©  ^ 
pound  (1/16  of  a  cent),  hence  it  was  used  sparingly 
in  this  cremation.  About  two  armsful  had  been  pro- 
cured. A  pile  of  round  dry  chips,  each  about  the  size 
of  a  soup  plate,  was  to  be  the  principal  fuel.     These 


via.    U(i. — Tower    iictii-    Uullii. 


INDIA.  329 

chips  are  made  of  stable  iiiauure  mixed  with  rice  straw. 
In  the  soft  state,  they  are  attached  to  walls  and  the 
outside  of  houses,  where  they  are  dried  in  the  sun,  and 
are  used  extensively  as  fuel.  They  are  the  prototype 
of  the  "buffalo  chips"  of  our  western  prairies.  The 
ground  was  first  covered  with  several  layers  of  these 
chips  over  an  area  a  little  in  excess  of  the  width  and 
length  of  the  corpse;  pieces  of  dry  wood  were  then  laid 
across.  (Fig.  63.)  The  body  was  then  prepared  by 
tlie  brother;  the  highly  colored  cloth  was  removed;  the 
face  was  vrrapped  in  a  cloth  and  was  never  exposed 
while  the  brother  washed  it  with  water  dipped  from 
the  nearby  Jumna.  ]Srext  the  glass  bracelets  were 
broken  with  a  piece  of  wood.  The  body,  in  a  cheap, 
well-worn  calico  dress,  was  placed  on  the  layer  of  wood 
and,  lastly,  chips  were  piled  on  all  sides  and  over  the 
corpse.  A  small  bundle  of  dry  brush  was  then  pur- 
chased, for  four  annas,  and  distributed  over  the  sides 
and  top  of  the  small  mountain  of  chips.  A  handful 
of  rice  straw  was  then  taken  from  the  litter,  twisted 
into  a  torch,  ignited  by  one  of  the  old  men,  swnng  by 
the  brother  until  it  burned  in  a  bright  flame,  and  with 
this  the  dry  brush  was  set  afire  at  the  head  of  the  corpse. 
The  breeze  was  in  the  right  direction,  and  in  a  few  mo- 
ments the  entire  pile  was  ablaze,  the  chips  caught  fire 
and  soon  the  odor  of  burning  flesh  escaped  witli  tlie 
smoke.  It  was  at  this  stage  of  the  cremation  tliat  I 
was  as  anxious  to  leave  as  I  had  been  at  first  to  wit- 
ness it.  We  left  the  mourning  party  jabbering,  laugh- 
ing, smoking  and  looking  lazily  and  unfeelingly  into 
tlie  smouldering  fire  maintained  by  the  chips.  During 
our  stay,  tlie  ashes  of  the  two  corpses  previously  cre- 
mated were  thro"\vn  into  the  Jumna  Eiver.  On  a  knoll 
overlooking  the  river  a  Brahmin  priest  was  perched, 
awaiting  the  funeral  procession  of  a  corpse  attended 
by  mourners  who  could  pay  him  for  his  priestly  func- 
tions. He  did  nothing  for  the  poor  young  woman  whose 
corjise  was   now  being   devoured   by   the   smouldering 


330  AROUND  THE  WORLD  VIA  INDIA. 

fire  furnished  by  the  cheapest  fueL     He  did  not  have 

to  wait  long  to  assist  in  the  happy  incarnation  of  the 

soul  of  one  of  his  faith.     In  returning  to  the  city  we 

met   another   funeral  procession,    chanting    the    same 

funeral  dirge,  but  to  outward  appearances  the  mourners 

belonged    to    a    higher  caste.     They  were  well  dressed 

and  undoubtedly  expected  to  pay  the  priest  liberally 

for  his  services. 

"It  is  a  brief  period  of  life  that  is  gi'anted  us  by 
Nature,  but  the  memory  of  a  well-spent  life  never 
dies." — Cicero. 

TAJ   MAHAL. 

The  Eoyal  Tomb,  Taj  Mahal,  at  Agra,  is  the  most 
costly  and  the  most  beautiful  mausoleum  in  the  world. 
It  was  built  by  Emperor  Shahjehan  Jeman  for  his  wife, 
Bagum.  It  was  commenced  in  1629  and  completed 
in  1648.  It  is  the  most  significant  landmark  of  the 
power,  glory  and  wealth  of  Turkish  rule  in  India,  and 
Agra  to-day  is  a  very  important  stronghold  of  Moham- 
medanism in  India,  as  one-half  of  its  population  of 
150,000  are  Mussulmen.  How  so  much  money  could 
be  spent  in  memor}^  of  even  a  beloved  empress  surpasses 
all  understanding.  (Fig.  65.)  The  entrance  to 
the  building  which  contains  the  tomb  is  a  specimen 
of  exquisite  architectural  art.  From  the  entrance  a 
pathway,  paved  with  the  purest  white  marble,  leads 
to  the  main  building,  lined  by  columns  of  the  same 
material  and  on  each  side  a  row  of  arbor  vitae,  the  tree 
so  constantly  found  in  Mohammedan  cemeteries. 

"Thou  must  leave  thy  lands,  house  and  beloved 
wife,  nor  shall  any  of  those  trees  follow  thee, 
their  short-lived  master,  except  the  hated  cy- 
press."— Horatius. 

The  passage  between  pools  and  fountains  and  lovely 
flowers  and  shrubbery  up  to  the  steps  of  the  magnificent 
marl)le  building  characterized  by  S5Tnmetry  and  beauty 
in  which  the  precious  ashes  of  the  empress  have  found 
their  last  resting  place,  is  unequaled  in  the  world  for 
its  exquisite  architectural  design.     The  real  tomb  is  in 


Fig.  68. — Native  policemen. 


INDIA.  333 

tlie  basement,  side  by  side  with  that  of  her  hiLsband. 
The  emperor  had  planned  a  separate  mausoleum  for 
himself  of  black  marble  on  the  opposite  side  of  the 
Jumna.  The  building  was  commenced  on  a  large 
scale,  but  death  overcame  him  prematurely  and  he  now 
shares  the  ample  space  of  the  mausoleum  which  was 
intended  exclusively  for  the  last  resting  place  of  his 
Avife. 

DELHI. 

Delhi  is  unquestionably  the  most  interesting  city  in 
India.  I  mean  by  this  not  Delhi  of  to-day  with  its 
300,000  inhabitants,  but  the  Delhi  of  long,  long  ago 
with  its  ruins  of  palaces,  temples  and  tombs  spread- 
ing over  a  length  of  ten  miles  by  a  breadth  averaging 
a  little  less  than  six.  In  this  area  are  comprised  the 
traditional  "seven  castles  and  fifty-two  gates"  spoken 
of  as  far  back  as  1611  by  the  merchant  Finch.  This 
entire  area  is  literally  strewn  with  remnants  of  the 
glory  of  the  Delhi  of  the  past.  The  palace  of  the 
Moguls  within  the  fortress  of  Delhi  is  a  magnificent 
sjDecimen  of  Indian  architecture,  a  combination  of  sym- 
metry and  beauty  of  design.  The  road  from  Delhi 
to  the  old  toAvn  of  Qutab,  twelve  miles  distant,  passes 
over  and  on  each  side  as  far  as  the  eye  can  reach  ruins 
of  former  wealth  and  power  come  into  view.  In  this 
great  stretch  of  country  millions  and  millions  of  peo- 
ple have  lived  and  struggled  centuries  ago  when  Delhi 
was  the  Eome  of  India.  (Fig.  66.)  The  most  con- 
spicuous landmark  of  ancient  history  here  is  the  min- 
aret Qutab,  238  feet  high,  sloping  from  the  foot.  Al- 
though struck  twice  by  lightning,  it  remains  in  a  good 
condition  of  preservation,  a  strong  reminder  of  the 
former  powerful  Mohammedan  reign.  The  remaining 
historical  ruins  of  Old  Delhi  in  the  immediate  neigh- 
borhood of  the  colossal  minaret  are  the  mosque  and 
tombs  of  x\ltamsli  and  Adham  Khan,  noted  for  their 
simplicity   and   architectural    beauty.     I    met    here   a 


334  AROUND    THE    WORLD    VIA    INDIA. 

guard,  a  native,  an  old  veteran  who  served  under  Lord 
Eoberts  during  the  Cabul  war.  He  was  proud  of  the 
decoration  he  wore  on  his  breast,  but,  like  all  other 
guards  in  charge  of  public  institutions,  his  right  hand 
was  converted  into  a  big  shallow  cup  for  the  reception 
of  a  handsome  tip  when  I  was  ready  to  say  goodbye. 
I  took  breakfast  at  the  Eest  House,  kept  by  a  Turk. 
In  view  of  the  nationality  of  the  host,  I  expected  to 
enjoy  a  good  cup  of  coffee.  The  stuff  that  was  served 
as  coffee  was  absolutely  beyond  criticism.  I  asked  to 
be  shown  the  coffee  used  in  its  preparation.  I  was 
handed  a  package  wrapped  in  a  yellow  paper  and  con- 
taining a  pitch  black  pasty  mass.  It  bore  the  follow- 
ing delusive  label:  '^Symington's  French  coffee,  pre- 
pared as  in  Paris  and  blended  with  the  finest  chicory." 
Judging  from  the  taste  and  smell  of  the  black  infusion 
I  became  satisfied  that  it  was  made  from  poor  chicory 
without  even  a  blending  of  coffee.  During  our  return 
trip  the  mercury  in  the  thermometer  went  up  to  126  F. 

The  Royal  Palace  in  Delhi,  within  the  great  fort  on 

the  bank  of  the  Jumna  river    (Fig  67),  is  in  a  good 

state  of  preservation  and  an  imposing  example  of  ancient 

Indian  architecture.     The  great  temples,  old  and  new, 

scattered  all  over  India,  remind  one  very  forcibly  of: 

"No  nation  is  so  barbarous,  no  one  so  savage, 
whose  mind  is  not  imbued  with  some  idea  of  the 
gods.  Many  entertain  foolish  ideas  respecting 
them,  yet  all  think  that  there  is  some  divine 
power  and  nature." — Cicero. 

Their  grandeur  and  beauty  suggest: 

"There's  nothing  ill  can  dwell  in  such  a  temple; 
if  the  ill-spirit  have  so  fair  a  house,  good  things 
will  strive  to  dwell  within  it." — Shakespeare. 

A    PARSEE    WOMAN    DOCTOR. 

On  my  arrival  at  Jaipur  the  proprietor  of  the  Rustem 
Family  Hotel  informed  me  that  the  only  other  guest 
in  the  house  was  a  very  distinguished  Parseo  woman 
doctor.     He   said    that   her   reputation   has   spread    all 


INDIA.  335 

over  India  and  that  she  was  well  known  in  the  medical 
circles  of  Europe.  Naturally  these  statements  excited 
my  interest.  I  was  anxious  to  get  some  particulars 
of  the  medical  and  surgical  work  of  woinen  in  India 
and  to  obtain  additional  information  regaxding  the 
status  of  gynecology  and  obstetrics  in  this  country.  At 
dinner  she  occupied  a  seat  opposite  me  at  the  table. 
She  was  a  woman  well  beyond  blooming  youth  with  a 
yellow,  freckled  face,  coal  black  eyes  and  hair.  She 
was  dressed  in  flowing  silk  of  different  colors,  with 
ruby  red  in  the  lead,  and  displayed  a  profusion  of  what 
appeared  to  me  cheap  jewelry.  She  displayed  a  ner- 
vous disposition.  She  brought  a  new  book  with  her, 
which  she  seemed  not  to  read,  but  to  glance  over  in  a  very 
nervous  manner  during  and  between  courses.  The  at- 
tention paid  to  her  by  tlie  waiters  proved  to  me  that 
she  was  no  stranger  in  the  house.  The  proprietor  of  the 
house  was,  like  her,  a  Parsee,  a  fire  worshiper.  From 
the  appearance  and  behavior  of  the  woman  I  became 
satisfied  that  I  had  a  colleague  to  deal  with  from  whom 
I  had  little  to  expect  in  the  way  of  professional  courtesy, 
and  yet  a  possible  opportunity  to  increase  my  stock  of 
medical  and  surgical  knowledge  from  such  a  rare  source 
was  too  tempting  not  to  make  an  effort  to  obtain  it. 
With  many  misgivings  I  made  the  attempt  very  cau- 
tiously. Nothing  but  an  occasional  timid,  lightning 
glance  was  exchanged  during  dinner.  After  dinner  I 
sent  my  servant  to  her  room  with  my  card.  He  re- 
turned a  few  moments  later  with  the  discouraging  in- 
formation^  "The  lady  is  too  tired."  Disappointed  as 
I  was  in  receiving  this  not  entirely  imexpeeted  news, 
I  had  the  satisfaction  of  knowing  that  I  had  done  what 
I  deemed  my  duty.  The  next  day  I  was  "too  tired," 
because  in  the  meantime  I  had  ascertained  that  the 
much  famed  Parsee  woman  doctor  knew  more  about 
fire  worship  than  medicine.  A  strict  armed  neutral- 
ity was  maintained  on  both  sides  during  the  remain- 
ing time  we  were  obliged  to  live  under  the  same  roof 


336  AROUND    THE    WORLD   VIA    INDIA. 

and  to  eat  at  the  same  table.  A  red  cloth-boimd  book 
Avas  her  invariable  silent  table  companion.  It  was  not 
a  medical  book.  It  must  have  been  either  a  novel  or 
some  occult  treatise  on  fire  worship.  Of  the  meeting 
AAdth  this  woman  I  can  not  say,  as  of  all  other  mem- 
bers of  the  medical  profession,  that  I  had  the  pleasure 
of  meeting  on  my  long  journey: 

"Friendship,    mysterious    cement    of    the    soul. 
Sweet'ner  of  life  and  soldier  of  society." — Blair. 

A    SICK    ELEPHANT. 

From  Jaipur  I  made  a  trip  to  the  old  capital  city, 
Amer,  its  palace  and  wonderful  mountain  fortifications, 
eight  miles  distant  from  the  present  seat  of  government 
of  Jaipur  state.  The  old  city  is  enclosed  by  mountain 
ridges  1,500  to  2,000  feet  high,  all  strongly  fortified. 
The  city  is  now  in  ruins  and  nearly  deserted.  The 
palace  and  fortifications  are  in  good  repair.  It  was 
arranged  the  evening  before  that  I  should  go  by  car- 
riage as  far  as  the  l)ase  of  the  mountain,  where  an 
elephant  Avould  ho  in  waiting,  who  would  take  me  over 
the  mountain  ridge  to  the  old  city,  and  from  there  up 
the  steep  incline  to  the  palace  and  fortification.  When 
morning  came  I  was  informed  that  the  elephant  was 
sick  and  that  a  bullock  cart  would  be  sent  instead.  In 
making  inquiry  regarding  the  elephant's  sicloiess  I  as- 
certained that  the  huge  beast,  quite  old,  had  for  sev- 
eral years  been  sufi^ering  at  intervals  from  acute  attacks 
of  illness.  He  would  fall  do'v\Ti  suddenly,  with  great 
pain.  These  attacks  would  last  from  three  to  four 
hours,  when  he  would  recover  and  remain  in  apparently 
good  health  until  the  next  attack.  I  am  quite  con- 
fident tbat  tlii^  giant  l)east  is  the  subject  of  gallstones 
of  enormous  size  and  that  it  is  onl}^  a  question  of  a  short 
time  before  he  will  die  from  a  complicating  suppura- 
tive inflammation  of  the  bile  ducts.  When  we  came 
to  the  foot  of  the  mountain  the  bullock  cart  was  conspic- 
uous for  its  al)Sonce.  I  was  determined  to  see  the  old 
city,  palace  and  fortification,  and  there  was  no  other 


INDIA.  339 

alternative  leJ't  but  to  make  the  trip  of  two  miles  and  the 
climb  of  1,500  feet  on  foot  in  a  temperature  of  132  F. 
as  registered  by  my  thermometer.  It  is  needless  to  say 
that  when  I  reached  the  palace  my  clothes  were  not 
only  wet  throngli  and  through,  hut  my  feet  and  socks 
were  soaked  in  sweat  that  ran  down  the  legs  in  streams. 
After  seeing  the  sights  the  belated  bullock  cart  ar- 
rived, and  on  it  I  made  the  return  trip.  The  cart  was 
a  first-class  one,  but  what  a  vehicle !  I  first  tried  to 
ride  a  la  native  by  doubling  myself  up  in  monkey  style. 
As  the  springless  rough  cart  jumped  over  the  stones, 
into  and  out  of  ruts,  this  position  soon  became  unend'or- 
able.  If  it  had  not  been  for  my  inborn  pride  to  sur- 
mount hardships  I  would  gladly  have  jumped  out,  paid 
the  owner  and  his  old  wife,  who  accompanied  us  and 
who  helped  her  spouse  in  keeping  the  bullocks  in  mo- 
tion, for  their  trouble,  and  returned  as  I  came,  on  foot. 
As  it  was,  I  rendered  my  position  endurable  by  sitting 
crosswise  in  the  cart  with  the  numb  legs  hanging  over 
one  of  the  immense  wooden  wheels.  I  made  up  my 
mind  at  the  time  that  as  long  as  I  remained  in  India 
I  would  ride  on  anything  else  but  a  bullock  cart.  It 
was  my  first  and  last  experience  with  this  rude  anti- 
quated native  vehicle. 

A    CROCODILE    TANK. 

In  the  rear  of  the  palace  of  the  maharajah  of  Jaipur 
is  a  tank  covering  several  acres  and  containing  a  green- 
ish turbid  water  covered  for  the  most  part  with  the 
scum  of  algae.  It  is  inhabited  by  crocodiles  and  tur- 
tles. Stone  steps  lead  down  from  the  palace,  to  the 
edge  of  the  water.  On  the  advice  of  the  guide  we  had 
brought  with  us  from  a  nighboring  butcher-shop  delica- 
cies with  which  to  feed  the  crocodiles.  As  soon  as  we 
reached  the  edge  of  the  tanlv  a  palace  guard  commenced 
to  make  a  barking  noise  and  in  a  few  minutes  some- 
thing appeared  on  the  surface  of  the  water  which 
looked  like  a  black  log  about  fifteen  feet  lon^.     The 


340  AHOUXD    THE    WORLD   VIA    INDIA. 

scuttling  motion  of  the  smaller  end  of  the  log  showed 
that  it  was  a  crocodile  on  tlie  way  to  accept  the  prof- 
fered invitation  for  tiffin.  Slowly,  lazily,  the  mon- 
ster approached,  and  as  it  came  up  to  the  steps  an 
immense  "moss-covered  head  with  small  slit-like  eyes  ap- 
peared above  the  surface  of  the  water  with  the  cavern- 
ous mouth  wide  open,  displaying  two  rows  of  sawlike 
teeth.  With  unerring  aim  he  caught  the  fragments 
of  meat,  which  at  once  disappeared  from  the  tongueless 
mouth.  In  less  than  ten  minutes  four  other  crocodiles 
and  a  large  turtle  were  our  guests.  One  of  the  largest 
of  the  beasts,  a  monster  at  least  twenty  feet  long,  took 
the  liberty  to  climb  the  steps  in  order,  I  presume,  to 
cultivate  a  closer  acquaintance  with  us.  A  few  blows 
with  a  club  administered  over  the  skull  by  the  guard 
brought  him  to  a  standstill,  and  vnth  a  tremendous 
splash  he  returned  to  his  proper  element  and  disap- 
peared from  sight. 

A  BELATED  BRIDAL   CEREMONY. 

One  Sunday  afternoon,  while  driving  through  one 
of  the  principal  streets  of  Jaipur,  I  heard  the  ear-kill- 
ing strains  of  native  musicians.  I  brought  the  car- 
riage to  a  standstill  and  a  procession  soon  made  its 
appearance,  headed  by  the  band.  It  was  made  up 
exclusively  of  Avomen,  from  four  to  six  abreast,  each  of 
them  carrying  on  the  head  a  liasket  containing  sweets 
and  other  small  presents.  It  was  explained  to  me 
that  this  procession  was  in  honor  of  a  woman  who  in 
four  weeks  would  make  her  first  addition  to  the  census 
of  the  ^ity.  It  wa?  not  difficult  to  locate  the  bride  of 
eight  months  in  the  first  row  of  the  procession.  The 
husband  was  not  there.  He  was  at  home  awaiting  the 
presents  from  his  father-in-law,  conveyed  to  him  by 
the  members  of  the  procession.  Later  in  the  day  I 
saw  another  procession  on  a  larger  scale  announcing  to 
the  public  a  similar  event.  This  custom,  which  to  me 
appeared  a  praiseworthy  one,  is  generally  observed,  and 


INDIA.  341 

if  the  census  taker  of  Jai])iir  keeps  his  cars  ready  and 
his  eyes  open,  he  has  no  difficulty  in  keeping  track  of 
the  increase  of  the  population. 

FEAST  OF  THE  NEW   MOON. 

As  I  was  elbowing  my  way  through  the  crowded 
streets  of  Jaipur,  on  Sunday  evening,  soon  after  sun- 
down, I  saw  thousands  of  eyes  looking  in  the  direction 
in  which  the  scorching  sun  had  so  recently  disappeared. 
I  was  told  that  it  was  the  feast  of  the  new  nroon.  It 
was  a  long  time  before  I  could  see  the  goddess  tliat 
was  the  object  of  worship  that  evening.  I  finally  could 
make  out  the  faintest  outlines  of  a  pale  little  sickle — 
it  was  tlie  new  moon.  A  great  procession  formed  in 
honor  of  the  event,  headed  by  a  native  band,  a  gaudily 
capai-isoned  elephant,  a  squad  of  police,  and  followed 
by  a  company  of  native  soldiers.  The  moon  is  held  in 
high  esteem  as  a  goddess  by  both  Brahmins  and  Bud- 
dhists, and  the  new  moon  is  always  greeted  with  joy 
and  heralded  by  a  religious  procession. 

A  FAITHFUL  ROMAN  CATHOLIC  PRIEST. 

At  Abu  Eoad  a  gentleman,  plainly  dressed,  with  full 
beard  well  peppered  with  gray,  entered  my  compart- 
ment and  at  once  entered  into  a  lively  conversation. 
He  spoke  English  as  it  is  spoken  in  England  and  I  took 
him  for  an  Englishman,  probably  an  employe  in  the 
civil  service.  In  removing  liis  cheap  gray  helmet  I 
noticed  that  the  top  of  his  head  as  large  as  the  palm 
of  the  hand  was  shaved.  There  was  now  no  doubt  in 
my  mind  concerning  the  vocation  of  my  new  compan- 
ion. He  informed  me  that  he  was  a  Eoman  Catholic 
priest,  and  furthermore,  that  he  was  a  native  of  Swdtzer- 
land,  had  been  in  India  since  he  entered  the  priesthood 
26  years  ago,  and  that  for  eight  years  he  had  served  as 
chaplain  in  the  army,  and  was  now  on  his  way  to  visit 
a  detaclunent  of  troops  at  Ahemabad.  It  further  de- 
veloped that  our  birthplaces  in   Switzerland  were  not 


342  AKOUXD    THE    WORLD   VIA    INDIA. 

far  apart.  It  was  a  strange  coincidence  that  I  should 
find  liere  in  tlie  wilds  of  India  a  countryman  whose 
cradle  was  so  near  to  mine.  Eev.  B.  Jost,  S.J.E.C. 
chaplain^  has  spent  his  whole  professional  life  in  India 
as  a  miissionary  and  chaplain.  He  has  never  taken  a 
vacation.  He  has  seen  the  horrors  of  famine  and  the 
ravages  of  cholera^  and  other  devastating  epidemic 
diseases  and  has  but  once  left  his  post  when,  stricken 
by  fever  and  dysentery,  his  physician  insisted  on  his 
being  talien  to  Bombay  to  save  his  life.  He  was  ten- 
derly nursed  by  his  brother  priests,  who  for  a  long  time 
had  no  hope  that  he  would  recover.  His  vigorous  Helve- 
tian constitution  and  determined  will  triumphed.  He 
recovered  and  at  once  returned  to  his  station.  During 
the  last  famine,  which  extended  over  four  years,  he 
spent  the  money  sent  to  him  by  friends  in  buying  food, 
and  dealt  out  rice  and  peas  with  his  own  hands  during 
the  hottest  months  of  the  year  and  was  the  means  of 
saving  600  lives  from  starvation.  He  had  exposed  him- 
self to  all  kinds  of  privations  and  dangers.  In  one  day 
he  dispatched  four  of  the  most  deadly  vipers  in  his 
yard  and  bungalow.  All  honor  to  such  a  brave,  faith- 
ful servant  of  the  Eoman  Catholic  church. 

"Calamity  is  an  opportunity  to  show  one's 
virtue." — Seneca. 

"Fire  tries  gold,  misery  tries  brave  men." — 
Ibid. 

ELEPHANTA    CAVES. 

The  most  interesting  place  I  visited  during  my  stay 
at  Bombay  was  the  Cave  Temple  in  Elephanta  Island, 
one  hour  and  a  half  by  sailboat  from  the  city.  The  ele- 
phant's island  is  about  three  miles  in  circumference,  is 
forest-clad  and  interlaced  with  a  very  pretty  creeper, 
which  blossoms  more  than  half  of  the  year.  The  caves 
which  in  reality  are  a  large  Brahmin  cave  temple,  are, 
according  to  Hindu  tradition,  4,000  years  old.  There 
are  five  caves,  but  the  one  usually  visited  is  the  Great 
Cave,  which  is  located  about  250  feet  above  the  level 


INDIA.  345 

of  the  sea.  It  is  hewn  out  of  solid,  hard  rock,  it  is 
about  130  feet  long  and  of  the  same  width,  and  17  feet 
high.  At  present  it  is  only  used  as  a  place  of  worship 
on  occasions  of  Shiva  festivals,  and  in  the  middle  of 
February  a  religious  fair  is  held  here.  The  sculptures 
which  ornament  the  walls  are  cut  out  of  the  rock  as 
well  as  the  columns  which  support  tlie  stone  ceiling. 
All  of  them  show  the  ravages  of  time.  Some  of  the  col- 
umns are  destroyed  whole  or  in  part,  and  large  pieces 
have  been  split  off  from  many  of  the  mural  figures. 

'In  short,  do  you  not  see  stones  even  yield  to 
the  power  of  time;  lofty  towers  fall  to  decay  and 
rocks  moulder  away?  Temples  and  statues  of  the 
gods  go  to  ruin,  nor  can  the  gods  themselves  pro- 
long their  dates  or  give  reprieve  from  fate." — 
Lucretius. 

Of  the  nine  allegorical  figures  illustrating  the  Brah- 
min cult  I  will  only  briefly  describe  the  central  one 
which  represents  Brahma,  the  creator;  that  on  the  right 
is  Vishnu,  the  preserver,  and  Shiva,  the  destroyer,  on 
the  left.  This  is  the  most  elaborate  and  striking  of  the 
sculptures.  Brahma's  face  is  expressive  of  peace,  kind- 
ness and  reflection.  If  the  artist  of  this  exquisite  work 
of  art;  made  any  mistake  it  was  in  sparing  stone  in  form- 
ing the  thick  everted  lips.  Brahma  holds  a  lotus  flower 
in  his  left  hand;  Shiva  holds  the  deadly  serpent,  tlie 
cobra.  The  significance  of  the  pomegranate  is  creation; 
that  of  the  lotus  flower  preservation,  and  that  of  the 
ugly  snake  in  threatening  attitude,  destruction.  The 
figures  on  each  side  are  supposed  to  be  doorkeepers, 
each  attended  by  a  dwarf.  The  figures  of  this  master- 
piece of  the  sculptor's  art  of  4,000  years  ago  are  well 
preserved  and  a  study  of  them  will  satisfy  any  observer 
of  the  great  skill  of  Indian  artists  of  that  remote  period. 
In  front  of  the  open  temple  is  a  small  tank,  in  the 
shallow  water  of  which  a  number  of  pigmy  frogs  enjoyed 
their  childish  frolic.  No  one  can  visit  this  venerable 
cave  temple  without  becoming  deeply  impressed  with 
the  art  of  India  long  before  the   infant    Moses    was 


34G  AUOUXD    THE    WORLD    VIA    INDIA. 

re,-?uced  from  the  crocodile  infested  Xile  and  long  before 
Romulus  was  weaned  from  the  breast  of  his  ferocious 
wet  nurse. 

A  GHEWSOME   CHAIJNEL   HOUSE. 

The  Parsee  people  who  came  from  Persia  to  India 
centviries  ago,  and  of  whom  there  are  now  about  100,- 
000  in  Bombay,  are  fire  worshipers,  and  neither  Inirn 
nor  cremate  their  dead.  They  dispose  of  their  dead 
by  exposing  them  in  a  place  where  vultures  can  devour 
them  in  peace  and  safety.  The  Towers  of  Silence  is 
the  place  where  the  hundreds  of  vultures  are  fed  by 
the  jjodies  of  the  dead  Parsee.  These  towers,  five  in 
number,  and  the  Fire  Temple,  the  place  of  Parsee  wor- 
ship, are  located  on  ^lalabar  Hill,  in  elevated  beauti- 
ful grounds  which  have  an  area  of  over  75,000  square 
vards.  These  grounds  are  surrounded  by  a  high  stone 
wall  and  strangers  are  not  admitted  without  a  spe- 
cial permit.  (Fig.  70.)  The  Towers  of  Silence,  the 
largest  of  Avhich  measures  2T6  feet  in  circumfer- 
ence, are  all  surrounded  by  high  walls,  al)out  2~)  feet 
in  height,  and  have  an  opening  on  the  ground  level, 
through  which  the  dead  bodies  are  carried.  The  corpse 
bearers  are  the  only  persons  allowed  to  enter  the  towers. 
Tlie  bodies  of  the  deceased  are  laid  in  grooves  around  the 
well,  which  is  in  the  center  of  the  tower.  The  corpses 
of  children  are  laid  in  the  center  circle,  those  of  the 
wonion  in  the  second  and  those  of  the  men  in  the  outer 
ring.  The  bodies  exposed  in  this  manner  are  in  a  short 
time  stripped  of  the  flesh  by  the  hundreds  of  vultures 
that  are  always  in  waiting  for  the  arrival  of  the  dead, 
and  then  the  bones  are  thrown  into  the  well,  where  they 
are  allowed  to  decompose.  On  the  day  I  visited  this 
grewsome  spot  I  saw  hundreds  of  these  bird  cannibals 
perched  in  neighboring  trees  and  on  top  of  the  towers, 
their  gizzards  evidently  gorged  Anth  human  flesh,  mo- 
tionless, hanging  heads,  drooping  eyelids,  sleeping. 
dreaming  of  the  next  feast  on  the  first  corpse  of  the 


INDIA.  347 

conimimit}'  oi'  lire  worshipers.     Slioiild  Uic  interval  be- 

tMcen  the  dead  marches  be  a  long  one,  these  cannibals 

of  the  air  will  be  very  hungry,  a  lively  struggle  will 

ensue  for  a  share  of  the  body  exposed,  fingers,  toes  and 

other  parts  of  the  body  will  be  torn  off  and  carried  away 

to  some  quiet  retreat,  to  be  devoured  at  leisure.     It  is 

in  this  way  tJiat  parts  of  the  skeletons  of  the  Parsee 

dead  find  their  way  into  the  dooryards,  streets,  gardens' 

and  on  to  house  tops,  grewsome  relics  of  a  grewsome 

practice  of  disposing  of  the  dead. 

In  conclusion,  it  is  to  me  a  source  of  great  pleasure 

to  extend  my  sincerest  thanks  to  the  members  of  our 

noble  profession  Avhom  I  had  the  opportunity  to  meet 

and  to  whom  I  am  deeply  indebted  for  their  uniform 

courtesy  and  charming  hospitality  . 

S.  S.  Kroxprinz  Wilhelm,  Harbor  of  New  York,  Oct.  11, 
1904. 


111^  '"■/iVTftf  n*;  ifrr":';*'  '  'f'.rwn  r^'w  'ty 


ll  III  II  lllllll  II  ll  till  111  lllllllllll  lllllll 

A  A      000  217  287    2 


